TREATMENTS
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Neurodiagnostic Testing
Neurodiagnostic testing, or electrodiagnostic testing, is a method to evaluate the physiologic function and nerves and muscles. It is used to diagnose peripheral nerve injuries such as carpal tunnel syndrome and spinal nerve injuries causing sciatica or radiculopathy.
Dr. Scott holds the highest level training and board certifications needed to complete these studies and has been doing so for over 20 years. EMG/NCS studies, as they are often called, involve the stimulation of multiple nerves and the measurement of physiologic muscle responses. The tests involve tiny surface electrical stimulations and the placement of wired acupuncture type needles into several muscles to measure muscle activity. The electrical stimulation portion of the test is also known as nerve conduction studies or NCS. These are not really painful but feel like a very small shock that may cause muscles to twitch briefly. Needle electromyography, EMG, does not involve any electricity or stimulations 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 it’s placement in many muscles but in some muscles can cause a sharper cramping sensation that is uncomfortable. For this reason Dr. Scott applies a local anesthetic to the skin prior to placing the needles.
While many people are apprehensive regarding what they’ve heard or may expect regarding these procedures 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
These procedures are used to diagnose and treat low back pain caused by inflamed, strained, or arthritic joints in the back and neck. The joints line the spine on both sides, lie deep to the paraspinal muscles but closer to the skin than the discs and nerves. Pain is typically local, worsened with standing or with any prolonged position, and worsened with leaning back as opposed to bending forward. Pain is not associated with any numbness or tingling in the arms or legs. Each joint is typically fed by 2 tiny nerves that transmit pain signals from the joints towards the brain.
Facet blocks: A physician, using an x-ray machine, can inject the joints with a very small amount of anesthetic and cortisone to provide pain relief that may last from several weeks to several months. These work best to treat pain following injuries or to treat flares of pain and those of chronic conditions. Chronic pain due to facet joint conditions is typically initially addressed with medial branch blocks.
Medial Branch blocks: This procedure involves the placement of local anesthetic only on the tiny nerves to the facet joints, for the purpose of diagnosing which joint(s) causes the pain. The local anesthetic lasts about 8 hours. If the patient’s pain resolves for this period of time than we have identified the source of pain, the facet joint. The patient may then be a candidate for radiofrequency ablation (AKA facet rhizotomy) procedures, to provide longer-lasting relief of pain from the facet joints.
Radio Frequency Ablation Procedures
Radiofrequency ablation procedures provide the most long-lasting treatment available for chronic spinal joint pain. Once the painful joint or joints is/are identified with diagnostic medial branch blocks (see above), then the physician, using X-ray guidance and an equipped needle, is able to create a very small radiofrequency lesion on the pain nerve to the joint(s). This procedure typically takes less than 5 minutes per joint, is completed with local anesthesia, and the benefit lasts 9 months to 2 years.
Services
Spinal Injury Assessment
Lower Dose Cortisone Injections
Spinal Injury Assessment
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 patien
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
Lower Dose Cortisone Injections
Spinal Injury Assessment
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
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.
Lower Dose Cortisone Injections
Lower Dose Cortisone Injections
Lower Dose Cortisone Injections
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
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.
Epidural Steroid Injections
Lower Dose Cortisone Injections
Lower Dose Cortisone Injections
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 a
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 Treatments
Platelet-rich Plasma Treatments
Platelet-rich Plasma Treatments
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
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.
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, 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
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.
Regenerative Medicine
Platelet-rich Plasma Treatments
Botox Treatments for Pain
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 harveste
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.