Wrist Tendon Pain
Evaluation:
This is a condition where the tendons in your hand (specifically in the first dorsal compartment) become inflamed. This can be caused by repetitive stress during common repetitive activities such as using a mouse at a desktop computer, or playing an instrument. It can also occur during pregnancy due to changes in the soft tissues of the body, including tendons and ligaments. Specifically, the hormone relaxin, which is produced in higher quantities during pregnancy, helps to relax the ligaments in the pelvis to prepare for childbirth. However, relaxin can also affect other joints and soft tissues throughout the body, potentially making them more susceptible to injury or inflammation.
Diagnosis for this disease may include a physical exam as well as ultrasound imaging, and possibly an EMG (nerve test).
Treatment:
Treatment options for this condition includes occupational therapy, bracing, a combination of ice and heat, non-steroidal anti-inflammatory type medications and Diclofenac gel.
Interventional treatments for this condition include corticosteroid injection into the first dorsal compartment utilizing ultrasound guidance.
Wrist Nerve Compression
Evaluation:
This is a condition in which the median nerve located in the middle of the wrist becomes inflamed from repetitive movements such as typing on a keyboard or using a mouse. It can also be from texting or scrolling on your phone. Pregnancy or any swelling in the upper extremities can cause increased risk for this condition.
This condition can be debilitating and can cause weakness and pain in the hands that can become permanent.
Diagnosis for this condition includes physical examination, ultrasound imaging, EMG (nerve test), and possibly an MRI.
Treatment:
Treatment for this condition includes splints for the hand, non-steroidal anti-inflammatory type medications, Diclofenac gel, ice and heat, compression sleeves as well as occupational therapy.
Interventional treatments include corticosteroid injections as well as hydro dissection of the nerve. If pain does not resolve with these treatments we may consider hand surgery referral and carpal tunnel release.
Spinal Ligament Thickening
Evaluation:
Over time, degeneration of the lumbar spine can cause the ligament behind your spinal cord to be thickened. This can lead to stenosis or pinching of the nerves of the spine, causing pain in your back and your legs in addition to decreasing your walking distance and causing you to have heavy feet.
Diagnosis for the condition includes physical exam, as well as x-rays and an MRI of the lumbar spine.
Treatment:
Treatment for this condition includes physical therapy, neuromodulators and non-steroidal anti-inflammatory type medications.
Interventional treatment for this condition includes lumbar epidural steroid injections as well as minimally invasive lumbar decompression. Minimally invasive lumbar decompression is utilized to de-bulk the ligamentum flavum to open up the spinal canal and provide you relief. This procedure is a outpatient procedure usually taking about 1 to 2 hours and you can return to normal activities within 3 to 4 days. If pain still persists after this procedure, referral may be needed to a spinal surgeon for further assessment.
Severe Headaches
Evaluation:
Migraines are a neurological condition characterized by recurring moderate to severe headaches, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light, sound, or smell. Migraines can be extremely debilitating, lasting anywhere from a few hours to several days. They can significantly impact your ability to function in daily life. Migraines are believed to be caused by a combination of genetic, environmental, and neurological factors, although the exact cause is not fully understood.
Diagnosis for the condition usually involves the consultation of a neurologist as well as laboratory tests and imaging studies.
Treatment:
Treatment for this condition includes oral medications as well as lifestyle changes such as reducing psychological stressors.
Interventional treatments offered for these conditions include Botox injections as well as greater occipital nerve blocks and third occipital nerve blocks / ablations.
Joint Wear & Tear
Evaluation:
This is a condition in which the wear-and-tear of your joints over time leads to a breakdown of those joints, as well as your ligaments. This can you persistent pain and decreased function. The exact cause of this condition is unknown. Most common presentation of osteoarthritis is in the knees as well as the hips, thought the condition can also include the spine or any other joint in your body.
Diagnosis for this condition includes a physical examination, x-rays and MRI.
Treatment:
Treatment for this condition can include acetaminophen (Tylenol), non-steroidal anti-inflammatory medications, neuromodulators and physical / occupational therapy. Bracing and / or assistive devices can be of great benefit.
Interventional treatments for this condition can include corticosteroid injections, hyaluronic acid injections (gel injections) and nerve ablations.
Widespread Pain
Evaluation:
This is a condition in which your nerves and muscles can become painful. The exact cause of his condition is unknown. It can be very debilitating and lead to decreased function.
Diagnosis includes physical examination as well as clinical decision making where we fully evaluate your symptoms, medical history, and physical examination findings. Other conditions must be ruled out before we make the diagnosis, as this is a diagnosis of exclusion.
Treatment:
Treatment for this condition includes neuromodulators as well as aerobic exercise. Although difficult and uncomfortable at first, aerobic exercise has been shown to be tremendously effective at treating fibromyalgia. We recommend that you consult with your primary care physician before starting an exercise routine.
Spinal Fractures
Evaluation:
This is a condition in which the vertebral bodies have been compressed and can become painful. Multiple conditions can cause this such as osteoporosis, physical trauma and metabolic diseases.
Diagnosis includes a physical examination as well as imaging methods such as x-ray or MRI.
Treatment:
Treatment for this condition can include neuromodulators, non-steroidal anti-inflammatory medications, acetaminophen (Tylenol), physical therapy and bracing.
Interventional treatment for this condition includes kyphoplasty (inflating a balloon to restore bone height then injecting bone cement into the vertebral body) as well as vertebroplasty (a procedure in which a special cement is injected into a fractured vertebra). Both of these procedures stabilize the fracture site and help reduce pain.
Persistent Pain Disorder
Evaluation:
This is a condition in which the nerves become hyperactive leading to pain and physical weakness, which can make one feel feeble, or infirm. The exact cause of this condition is unknown.
Diagnosis includes a physical examination as well as clinical decision making.
Treatment:
Treatment for this condition can vary including neuromodulators, non-steroidal anti-inflammatory medications, acetaminophen and physical therapy.
Interventional treatments can include peripheral stimulation as well as spinal cord stimulation.
Imagine your body's nervous system as a vast network of highways that send signals, including pain signals, from every corner of your body to your brain. Peripheral stimulation focuses on the smaller "roads" or nerves located outside your brain and spinal cord (hence the term "peripheral").
In this treatment, a small device is used to send mild electrical pulses directly to the specific nerve or group of nerves believed to be the source of pain. Think of it as placing a traffic light on a road that's always congested due to constant pain signals. This traffic light (the stimulation device) regulates the flow, reducing the number of pain signals that can pass through to the brain. As a result, the brain perceives less pain, providing relief to the individual.
Spinal cord stimulation, is like managing the pain signals on a major highway—the spinal cord. The spinal cord is the main route through which pain signals travel from the body to the brain. By targeting this area, spinal cord stimulation aims to interrupt the pain signals before they reach the brain.
A device similar to the one used in peripheral stimulation is implanted near the spinal cord. This device generates mild electrical pulses that interfere with the pain signals traveling along the spinal cord. You can think of it as putting a speed bump or a detour on the highway, causing the pain signals to slow down or take a different route, so fewer of them reach the brain. This results in a significant reduction in the perception of pain.
Nerve Damage
Evaluation:
This is a condition in which the nerves become damaged over time. The condition can be caused by multiple factors including diabetes, vitamin deficiencies and neurologic diseases.
Diagnosis for this condition includes a physical examination, an EMG (nerve test), possible nerve biopsy, blood work and imaging using MRI.
Treatment:
Treatment for this condition can vary including neuromodulators, non-steroidal anti-inflammatory medications, acetaminophen (Tylenol), capsaicin cream and physical therapy.
Interventional treatments can include spinal cord stimulation as well as peripheral stimulation.
Neck Nerve Pain
Evaluation:
This is a condition in which the nerves of the spine can become pinched. This can be caused by a herniated disc, arthritis or other space-occupying lesion. This condition causes pain in the neck as well as pain down the arms.
Diagnosis for the condition includes a physical examination as well as imaging such as an x-ray or MRI.
Treatment:
Treatment for this condition includes neuromodulators, non-steroidal anti-inflammatory medications, steroids, acetaminophen (Tylenol) as well as physical therapy.
Interventional treatments include epidural steroid injections in both the neck and back. Lumbar radiculopathy can be treated in multiple ways with minimally invasive procedures such as ligamentum flavum debulking and interspinous spacers. Referral may be needed to spine surgery for further management. If you are not deemed a surgical candidate, then spinal cord stimulation may be an option to help reduce your pain.
Spinal Disk Injury
Evaluation:
This is a condition in which the shock absorbers within the spine (intervertebral discs) become damaged and possibly rupture leading to compression of the nerves of the spine.
Diagnosis for this condition includes a physical examination, possible EMG (nerve test), and imaging methods such as x-rays or MRI.
Treatment:
Treatment for this condition includes physical therapy, weight loss, neuromodulators, non-steroidal anti-inflammatory medications and/or acetaminophen (Tylenol).
Interventional treatments for this condition can include epidural steroid injections or a referral to a spinal surgeon for further evaluation.
Lower Back Pain
Evaluation:
This is a condition in which the nerves of the spine can become pinched. This can be caused by a herniated disc, arthritis or other space-occupying lesion. This condition causes pain in the lower back as well as pain down the legs.
Diagnosis for the condition includes a physical examination as well as imaging such as an x-ray or MRI.
Treatment:
Treatment for this condition includes neuromodulators, non-steroidal anti-inflammatory medications, steroids, acetaminophen (Tylenol) as well as physical therapy.
Interventional treatments include epidural steroid injections in both the neck and back. Lumbar radiculopathy can be treated in multiple ways with minimally invasive procedures such as ligamentum flavum debulking and interspinous spacers. Referral may be needed to spine surgery for further management. If you are not deemed a surgical candidate, then spinal cord stimulation may be an option to help reduce your pain.
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Commack, NY 11725
2112 Middle Country Road
Centereach, NY 11720
800 Old Country Road
Riverhead, NY 11901
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