Services

We evaluate and treat all types of spinal injuries. These range from acute strains, recurrent spasms, and whiplash injuries to chronic pain due to disc problems, joint problems, and spinal nerve root problems. We perform the initial evaluation, order and review necessary imaging studies, and recommend treatments with the individual patient’s needs in mind. Dr. Scott treats patients with the goal of keeping each person as active as possible. Many times treatment simply involves education regarding the injury and appropriate exercise and activities. Other times it involves therapeutic intervention. Treatments often include diagnostic injections to help determine where the pain is coming from and therapeutic injections to treat pain in the problem.

Dr. Scott is fellowship-trained and board-certified to complete spinal injections, such as facet blocks, epidural steroid injections, nerve root blocks, and radiofrequency ablation procedures. Dr. Scott is especially interested in differentiating less common painful conditions that are often mistaken for spinal disorders. Shoulder problems are often confused with neck problems and hip problems are often confused with low back problems. Take the time necessary to determine which is the source of pain and limitations and to treat the injury appropriately.

Trigger point injections are used to treat muscle pain. Muscle pain often contributes to painful spinal conditions, either as the only source of pain or as one of a combination of sources for pain. Spinal pain may result from muscle pain, from joint pain, from disc pain, or from nerve pain. Muscle pain may involve spasm, is locally tender, and typically may be one-sided. Trigger point injections involve using a small and very thin needle to place local anesthetic medications into the tender muscle points.

Steroid medications (cortisone) are not typically used in trigger point injections. It remains unclear as to how trigger point injections work. Some believe that they block the release of local pain mediating chemicals while others believe that they lengthen or relax the muscles by changing the tension set point in the muscle.

Trigger point injections are very effective for acute injuries such as strains or sprains and provide temporary relief in chronic conditions, especially if the pain is flared. They are extremely safe as the needle small and goes no deeper than the superficial musculature.

Cortisone injections are often utilized to treat pain related to musculoskeletal injuries and spinal injuries. These injections typically include a mixture of local anesthetics and a corticosteroid medication. Pain is typically caused by inflammation. Corticosteroid, AKA cortisone, medications are potent anti-inflammatory agents typically used in injection preparations because they can be applied directly at the site of inflammation or pain.

All medications, including corticosteroids, have the potential for unacceptable side effects at high or continuous dosages. Our goal is to provide the lowest effective dosage. Dr. Scott has 20 years of experience in joint and spinal injections and draws from that experience to provide the lowest effective dosage in his injection procedures. Often times injections are completed for diagnostic purposes only and do not require cortisone at all.

This is the most common nonsurgical procedure used to treat sciatica caused by spinal nerve root

injuries. The nerve root can be injured due to a herniated disc or bone spur that puts pressure on the

nerve causing radiating pain from the spine. A strong anti-inflammatory medication, cortisone, is

injected into the (epidural) space near the affected nerve, reducing inflammation and relieving pressure

on the nerve. The doctor uses a rotating X Ray machine, a fluoroscope, to guide the needle accurately

and safely to the correct location. The procedure takes about 5 minutes to complete and typically

requires only a local anesthetic for comfort. The corticosteroid medication typically achieves full effect

within a few days and lasts for several months, allowing time for the nerve root to recover further.

Platelet-rich plasma is an increasingly popular method of treating painful tendon conditions and, in some cases, joint conditions. Platelet-rich plasma works, not as a drug, but as a stimulant to your body’s natural healing process. It involves using a small amount of your own venous blood and using a centrifuge to separate out a platelet concentrate called platelet-rich plasma. The platelet right plasma or PRP is then injected into the injured region. Platelets stimulate your body’s natural healing process, and in effect, jumpstart a slow healing or nonhealing injury.

Botulinum toxin, in various forms, is known to temporarily paralyze and relax muscle fibers. It is most commonly used for cosmetic purposes, by relaxing subcutaneous facial muscles and thus removing lines or wrinkles. Botox is medically approved to treat chronic migraine pain syndromes, by relaxing the muscles in the face, scalp, neck and upper back to break the pain feedback cycle that contributes to some chronic headache syndromes. Botox can also be effectively used to treat muscle pain syndromes in the same regions.

Botox may also be used to treat spasticity and pain related to spasticity.

There is has been a lot of Buzz lately about stem cell treatment over the last 10 years; mostly good, some bad.  Stem cells are basically cells that harbor the potential to stimulate regrowth of injured tissue, by dividing into the needed cells and forming new tissues needed to heal damaged or depleted tissues.  Stem cells can be harvested from one’s own tissues, including bone marrow and adipose or fat tissues, but only under a limited number of circumstances.