At your initial clinic visit, Dr. Paine will fully review your medical history and perform a physical examination to determine your course of treatment based upon your diagnosis and any treatments you may have already received. Diagnostic evaluation maybe required which can include neurological, laboratory and radiological testing. Each patient has a customized treatment plan which is specially designed for them.Your treatment many include one or more of the many types of procedures listed below. Additionally your treatment plan may include medications, dietary modifications, physical therapy, and psychological intervention to include biofeedback/relaxation training or nontraditional modalities such as acupuncture.
The services provided by Dr. Paine include:
-Acute Pain Management|
-Caudal Epidural Injection
-Cancer Pain Management
-Cervical and Lumbar Sympathetic Nerve Block
-Cervical Epidural Injection
-Cervical Facet Joint Injection
-Cervical, Thoracic and Lumbosacral Medial Branch Block
-Cervical, Thoracic and Lumbosacral Nerve Root Block
-Chronic Pain Management
-Complex Regional Pain Syndrome I & II
-Intercostal Nerve Blocks
-Intradiscal Electrothermal Therapy (IDET)
|-Low Back Pain|
-Lumbar Epidural Injection
-Lumbar Facet Joint Injection
-Neuropathic Pain Management
-Racz Catheter Lysis of Adhesions
-Sacroiliac Joint Injection
-Spinal Cord Stimulation
-Thoracic Epidural Injection
-Thoracic Facet Joint Injection
-Trigger Point Injections
PROCEDURES: General instructions.
-For most procedures, you should eat a light meal and take your routine medications unless otherwise instructed by your physician.
Discography: This is a procedure performed to assist the spine surgeon with surgical planning or to determine which disc or discs are causing the patient pain. A small amount of contrast is injected into various discs in the back to reproduce the patient’s pain.
Epidural Steroid Injections: There are a variety of indications for this procedure to include diagnosis and treatment of many painful conditions such as pain from herniated discs, shingles and spinal stenosis. The medication is delivered to the targeted tissues by placement into the epidural space which is an area located just outside the spinal canal. Steroids are extremely powerful anti-inflammatory medications and help to break the cycle of inflammation and pain and are usually injected along with a local anesthetic. This procedure is performed in the neck, upper or lower back or buttocks.
Intrathecal Pump Implantation: This is an advanced pain procedure. It is a surgical procedure where a catheter is placed into the spinal canal and is attached to a pump which is placed just under the skin in the abdomen. Pumps are refilled on a 1-2 month cycle. Candidates for this procedure must meet very strict criteria and the pumps are placed for either painful or spastic conditions.
Joint Injections: A joint may become painful due to injury or arthritis. Joint injections are performed for both diagnostic and therapeutic reasons. A small amount of medication is injected to the nerves that receive the painful signals from the joint.
Nerve Blocks: A variety of nerve blocks can be administered for either obtaining a diagnosis or for treatment of numerous painful disorders such as special types of headache, carpal tunnel syndrome, groin pain, etc.
Spinal Cord Stimulator Implantation: This is an advanced pain procedure. It involves placing electrical leads into the epidural space (just outside the spinal canal) and attaching them to a generator that is implanted just below the skin. Patients who benefit from this procedure are those with conditions such as Failed Back Surgery Syndrome and Complex Regional Pain Syndrome.
Sympathetic Nerve Block: A group of nerves called the sympathetic chain runs along the spine and some painful conditions are considered sympathetically mediated, meaning the pain travels along these chains. The injection of local anesthetics near these pathways is used to diagnose and treat pains that are sympathetically mediated.
Trigger Point Injections: Trigger points are small bands of muscle tissue in spasm and when compressed are painful and refer pain to other areas. An injection of local anesthetic with or without steroid into a trigger point can be very helpful in correcting this painful condition. The procedure only takes a few minutes to perform in the office and the patient is observed Trigger point injections are done in the office, and take approximately 5 minutes.