TREATMENTS
.jpg/:/cr=t:0%25,l:12.5%25,w:75%25,h:100%25/rs=w:1209,h:1209,cg:true)
Neurodiagnostic Testing
Neurodiagnostic testing, also known as electrodiagnostic testing, evaluates the physiologic function of nerves and muscles. These tests help diagnose peripheral nerve injuries, such as carpal tunnel syndrome, and spinal nerve injuries that can cause symptoms like sciatica or radiculopathy. Dr. Scott holds the highest level of training and board certifications required to perform these studies and has over 20 years of experience conducting them.
There are two parts to this study: nerve conduction studies (NCS) and needle electromyography (EMG). NCS is the electrical stimulation portion of the test. These are not particularly painful but feel like a slight shock that may cause muscles to twitch briefly. EMG does not involve any electricity or stimulation but involves the placement of a very small needle just under the skin into the underlying muscle. The needle is small enough that one may not feel its placement in many muscles, but in some muscles, it can cause a sharper cramping sensation that is uncomfortable. For this reason, Dr. Scott applies a local anesthetic to the skin before placing the needles.
While many people feel apprehensive based on what they’ve heard or expect, they are really not as uncomfortable as one would guess. Dr. Scott takes his time and does his best to make this experience as comfortable as possible.
Facet Blocks and Medial Branch Blocks
Facet blocks and medial branch blocks are procedures used to diagnose and treat neck or low back pain caused by inflamed, strained, or arthritic facet joints in the spine. These joints are located on both sides of the spine beneath the back muscles and are closer to the skin than the discs and nerves. Facet joint pain is typically localized rather than radiating. It often worsens with standing, prolonged positions, or leaning backward rather than bending forward, and is not usually associated with numbness or tingling in the arms or legs. Each facet joint is supplied by two tiny nerves that carry pain signals from the joint to the brain, which are targeted during these procedures to help identify the pain source and provide relief.
Facet blocks: Using X-ray guidance, a physician can inject the joints with a small amount of anesthetic and cortisone to provide pain relief that may last from several weeks to several months. These injections are most effective for pain following an injury or for flare-ups of chronic conditions.
Medial Branch blocks: Chronic facet joint pain is typically first evaluated and treated with medial branch blocks. This procedure involves placing a local anesthetic only on the tiny nerves that supply the facet joints for the purpose of diagnosing which joint(s) are causing the pain. The local anesthetic typically lasts about 8 hours. If the patient experiences significant pain relief during that time, it confirms the facet joint as the source of pain. Based on these results, the patient may be a candidate for radiofrequency ablation (also called facet rhizotomy), which can provide longer-lasting pain relief.
Radio Frequency Ablation Procedures
Radiofrequency ablation provides one of the longest-lasting treatment options for chronic spinal joint pain. Once the painful joint or joints are identified through diagnostic medial branch blocks, a very small radiofrequency lesion can be made on the nerve that transmits pain from the joint using X-ray guidance and a specialized needle. The procedure is performed with local anesthesia, typically takes less than five minutes per joint, and can provide pain relief lasting from nine months up to two years.
Services
Spinal Injury Assessment
We evaluate and treat the full range of spinal injuries, from acute strains, recurrent muscle spasms, and whiplash to chronic pain caused by disc problems, joint conditions, and spinal nerve irritation. Care begins with a thorough evaluation, including ordering and reviewing appropriate imaging when needed, followed by a personalized treatment plan based on each patient’s specific needs. Dr. Scott’s approach focuses on keeping patients as active as possible. In many cases, treatment simply involves education regarding the injury and appropriate exercise and activities. Other times, care may also include targeted therapeutic interventions, such as diagnostic injections to identify the source of pain and therapeutic injections to provide relief.
Dr. Scott is fellowship-trained and board-certified to perform spinal injections, including facet blocks, epidural steroid injections, nerve root blocks, and radiofrequency ablation. He has a special interest in identifying less common painful conditions that are often mistaken for spinal disorders. For example, shoulder problems can mimic neck pain, and hip conditions can present as low back pain. For example, shoulder conditions can mimic neck pain, and hip conditions can resemble low back pain. Dr. Scott takes the time to carefully determine the true source of each patient’s pain and limitations,
allowing for the most appropriate and effective treatment.
Trigger Point Injections
Trigger point injections are used to treat muscle pain. Muscle pain often contributes to painful spinal conditions, either on its own or alongside joint, disc, or nerve pain. Muscle pain may present as localized tenderness, sometimes with spasm, and is typically one-sided. Trigger point injections involve using a 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. These injections are very effective for acute injuries like strains or sprains and can provide temporary relief for chronic pain flare-ups. They are extremely safe as the needle is small and only reaches the superficial musculature.
Lower Dose Cortisone Injections
Cortisone injections are commonly used to treat pain from musculoskeletal and spinal injuries. These injections typically combine a local anesthetic with a corticosteroid (cortisone) medication. Because pain is often caused by inflammation, cortisone—a potent anti-inflammatory—is used in injections to deliver medication directly to the site of inflammation or pain.
All medications, including corticosteroids, have the potential for unacceptable side effects at high or continuous doses. Our goal is always to use the lowest effective dose. With over 25 years of experience in joint and spinal injections, Dr. Scott draws from that experience to provide the lowest effective dosage in his injection procedures. Oftentimes, injections are completed for diagnostic purposes only and do not require cortisone at all.
Epidural Steroid Injections
Epidural steroid injections are the most common nonsurgical treatment for 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 pain that radiates from the spine. Cortisone, a strong anti-inflammatory medication, is injected into the epidural space near the affected nerve to reduce inflammation and relieve pressure on the nerve. A rotating X-ray machine (fluoroscope) is used to guide the needle safely and accurately. The procedure takes about five minutes to complete and typically only requires a local anesthetic for comfort. The corticosteroid medication typically achieves full effect within a few days and can provide relief for several months, giving the nerve time to heal.
Platelet-Rich Plasma Treatments
Platelet-Rich Plasma Treatments
Platelet-Rich Plasma Treatments
Platelet-rich plasma (PRP) is an increasingly popular method of treating painful tendon conditions and, in some cases, joint conditions. Unlike medication, PRP works as a stimulant to your body’s natural healing process. A small sample of your own blood is drawn and spun in a centrifuge to create a concentrated platelet solution called p
Platelet-rich plasma (PRP) is an increasingly popular method of treating painful tendon conditions and, in some cases, joint conditions. Unlike medication, PRP works as a stimulant to your body’s natural healing process. A small sample of your own blood is drawn and spun in a centrifuge to create a concentrated platelet solution called platelet-rich plasma. The PRP is then injected into the injured region, where the platelets help jumpstart healing in slow-healing or chronic injuries.
Ultrasound-Guided Procedures
Platelet-Rich Plasma Treatments
Platelet-Rich Plasma Treatments
Dr. Scott completes many of his injections in the office using ultrasound technology to guide the needle tip to the proper location in the tissues or injected joints. Ultrasound allows for increased accuracy and increased safety with any injection procedure and is especially helpful when the procedure requires a high degree of precision.
Botox Treatments for Pain
Platelet-Rich Plasma Treatments
Botox Treatments for Pain
Botulinum toxin, commonly known as Botox, temporarily paralyzes and relaxes muscle fibers. It is most commonly used for cosmetic purposes to reduce wrinkles by relaxing subcutaneous facial muscles. It is also medically approved to treat chronic migraine pain syndromes by relaxing muscles in the face, scalp, neck, and upper back to break
Botulinum toxin, commonly known as Botox, temporarily paralyzes and relaxes muscle fibers. It is most commonly used for cosmetic purposes to reduce wrinkles by relaxing subcutaneous facial muscles. It is also medically approved to treat chronic migraine pain syndromes by relaxing muscles in the face, scalp, neck, and upper back to break the pain feedback cycle. Botox can also be used to relieve muscle pain in these areas, treat spasticity, and pain related to spasticity.
Regenerative Medicine
Platelet-Rich Plasma Treatments
Botox Treatments for Pain
Stem cell therapy has received a lot of attention over the past decade, with both promising and mixed results. Stem cells are special cells that can help repair injured tissue by developing into the types of cells needed for healing. They can be collected from a patient’s own body, such as from bone marrow or fat tissue, but only under a limited number of circumstances.