Frequently Asked Questions

Interventional pain management is the use of specialized procedures to treat acute or chronic pain. It may involve a combination of procedures or therapies such as injections, nerve blocks, chiropractic care, acupuncture, physical therapy, laser therapy, or other treatments. A pain management program is used for treating pain and managing future pain. The program is typically prescribed by a pain management doctor who has specialized training to evaluate, diagnose, and coordinate treatment for pain. A comprehensive pain management program may help restore a patient’s quality of life.

A pain management doctor is a physician who has specialized training in evaluating, diagnosing, and coordinating treatment for pain. Pain is a wide array of disorders including acute or chronic pain, and pain due to surgeries, injuries, trauma, diseases, or other medical conditions. As medicine learns more about the complexity of pain, it is important to have doctors with specialized knowledge of complex pain conditions and related diagnostic testing, and treatment options. In addition, interventional pain management physicians have specialized skills required to perform procedures such as spinal injections, nerve blocks, and other techniques to diagnose and treat pain.

Acute pain is a pain that begins suddenly and lasts less than 3 months. It can be sharp or severe, and generally has a specific cause such as surgery, injury, trauma, or infection.
Chronic pain is pain that lasts for 3 months or longer. It may be constant or recurring in regular or sporadic episodes. Chronic pain can have many causes including trauma, injury, disease, or other medical conditions. There are also cases of chronic pain without an explanation or apparent source. Some conditions that cause acute pain can also lead to chronic pain, such as trauma or injury. Chronic pain can have a severe impact on an individual’s quality of life and reduce their ability to conduct every day or enjoyable activities.

There are a variety of treatments, procedures, or therapies for treating back pain caused by conditions such as sciatica, disc bulges, or spinal stenosis. Some options include physical therapy, prescribed exercise programs, chiropractic treatment, and acupuncture. Other interventional treatments for back pain include spinal epidural injections, facet injections, nerve blocks, nerve ablation, non-surgical spinal decompression, and laser therapy.

Diagnostic spinal injections can be used to locate the source of pain due to spinal conditions. Injections can be given at a very specific location to determine if a particular nerve is the source of pain. The immediate response to the injection is closely monitored to determine if the nerve is the primary source of the pain. Other diagnostic spinal injections include discography (discogram), selective nerve root blocks (SNRB), sacroiliac joint injections, and facet joint injections.

A spinal epidural injection can be used therapeutically to relieve pain and to diagnose the source of pain (back, leg, arm, neck). Spinal injections involve injecting an anesthetic and an anti-inflammatory medication such as a steroid (cortisone) directly into the epidural space within the spine, near the affected nerve. This procedure can relieve pain and reduce inflammation. Spinal injections are typically only one part of a comprehensive pain management program.

In a healthy knee joint, hyaluronic acid lubricates the joint, allowing smooth movement in the knee. Severe pain can result when hyaluronic acid is diminished and the knee cartilage breaks down due to arthritis or another condition. Injections to the knee involve injecting hyaluronic acids into the joint to naturally replenish the joint fluid. This helps to eliminate the pain caused by lack of joint cartilage. The physician doing this procedure uses fluoroscopy (live x-ray technology), or ultrasound guidance, to precisely insert the injection.

An electromyography or EMG, is an electrodiagnostic test that records and analyzes the electrical activity of a patient’s muscles to help find the cause of conditions such as pain, spasms, numbness, tingling, weakness, and paralysis. EMG testing can provide physicians with specific information about the extent of nerve and muscle injury. During an EMG, a doctor inserts small, thin needles through a patient’s skin and into a muscle. A signal will be transmitted from the needle and through a wire to a receiver that’s connected to a special device. Results are often available immediately after the test is completed.

Micro-Vas Therapy (also known as Micro-Vascular) is a type of physical therapy treatment commonly used to stimulate blood flow in the feet. This treatment works for patients who have neuropathic pain caused by poor blood circulation due to diabetes or other conditions. During a Micro-Vas therapy treatment, the Micro-Vas unit is connected to the patient’s calf, ankle, and foot. Patients typically begin to experience relief after an average of 4 treatments.

Trigger point injection therapy is a treatment used to relieve pain caused by trigger points. Trigger points are small “knots” in muscles or connective tissue in the muscle which have been injured due to trauma or repetitive use. These points can create painful areas in the muscle which can radiate to other areas of the body. For this procedure, the physician injects a mixture of anesthetic and a corticosteroid directly into the trigger point to make it inactive and alleviate the pain. The injection is typically given multiple times until the painful area is relieved.

Platelet Rich Plasma Injection Therapy (PRP) is a treatment used to speed up the healing process of tendon injuries and osteoarthritis naturally, without subjecting the patient to risk or surgery.
PRP is plasma with many more platelets than what is typically found in blood. To develop a PRP preparation, blood is drawn from a patient. The platelets are separated from other blood cells and their concentration is increased with a process called centrifugation. The concentrated platelets are combined with the remaining blood and then injected into the affected area of the body. Platelet Rich Plasma Therapy has been shown to increase the speed of the natural healing process by an unusually fast degree. There is generally no risk to the patient because PRP uses the patient’s own blood. PRP has been used to treat conditions such as tendonitis and chronic back pain.

Radiofrequency ablation (or RFA) is a medical procedure used to manage severe chronic pain. It involves the use of radio waves to heat up an area of nerve tissue. By ablating the nerve, RFA disrupts the nerve’s ability to transmit pain signals to the brain. Patients who have experienced pain relief from nerve block injections may have pain relief from RFA. This treatment is typically used for chronic lower back pain, neck pain, and joint pain associated with arthritis.

Acupuncture has been used in Asia for centuries to relieve pain and treat other conditions. It also helps facilitate the body’s natural healing capabilities. During acupuncture procedures, an acupuncturist inserts extremely fine needles into the skin at specific acupoints. Acupuncture can be effective in relieving chronic pain in the neck, back, and knees, along with pain from tension headaches and migraines. It can also be used to treat other conditions.

Chiropractic therapy is focused on alleviating pain through body alignment and body structure. This therapy requires hands-on manipulation of the spine and extremities to improve function and relieve pain. Along with acupuncture and physical therapy, chiropractic therapy enhances the body’s self-healing processes and can prevent future pain. Chiropractic therapy can be an effective non-surgical treatment of disorders of the musculoskeletal system and nervous system. It is widely used to treat lower back pain, sciatica, herniated discs, neck pain, leg pain, and injuries.

Physical therapy or rehabilitation is a highly effective, but conservative treatment which can benefit individuals recovering from a variety of injuries, surgeries or medical conditions. Physical therapy can relieve pain, help avoid invasive procedures, and help heal an injury. It also promotes increased mobility and allows patients to regain their full function and quality of life. Patients can also experience improvements in their strength, motor function, and overall health by following a physical therapy program.

Your first visit generally involves a thorough exam, even if you were referred to our office by another provider. Your exam may include X-rays, lab tests and questions about your medical history. Please bring information about any prescription medications or over-the-counter supplements you currently take. Upon examination, a doctor, nurse or other medical professional will discuss your results and recommend a treatment plan. This is a great time to ask questions about your condition and our pain management services. We encourage you to play an active role in your recovery.

We accept many popular insurance plans, but we request that you please check with your provider regarding information about payments, deductibles and visit restrictions. Our front desk team can help you find this information. We also work with patients who have Health Savings Accounts (HSAs) and similar medical savings accounts or programs.

Yes, we accept patients who can cover treatment expenses without insurance. Ask us about our flexible payment options. We accept cash, credit cards, debit cards, money orders and checks.

Many of our facilities are open until 7 p.m. on weekdays to accommodate the busy lives of our patients. We typically have appointments for pain management services available between 10 a.m. and 7 p.m. Our Manchester office and surgery center opens at 9 a.m.

We don’t use a cookie-cutter approach to wellness. Every patient receives a customized care plan, so it’s difficult to predict how many appointments you will need. Some patients only need one appointment while others return multiple times over a series of weeks or months. The good news – or bad news, depending on how much you enjoy coming – is that you aren’t likely to visit us forever. We help get you better, and then we send you on your way with tools to manage your pain and prevent future ailments.

We treat nearly any condition that affects the spine or musculoskeletal system. We specialize in neurological and orthopedic conditions, but we aren’t limited to those treatments. Our team of doctors, nurses, physical therapists, chiropractors and acupuncturists treats everything from asthma to anxiety. If you have pain in any part of your body, we can probably help. We focus on nonsurgical pain management, but we are happy to send you to a surgeon when needed. If we feel like you won’t benefit from our care, we’ll let you know and refer you to an experienced specialist.

Many patients tell us they can’t feel their needles at any point during acupuncture therapy. Occasionally some patients experience minor discomfort when the needles are inserted, but this is rare. Our acupuncturists use very thin needles and insert them gently.

Musculoskeletal medicine addresses sports injuries, occupation injuries and age-related degeneration. Specialists who practice musculoskeletal medicine include physicians, physical therapists, chiropractors and acupuncturists. You can find all of these healthcare professionals at our facilities.