The Right Treatment Is Out There!
Our goal for you as our patient is to be able to offer the most effective yet most conservative non-opioid treatment for your painful issue. This means that if physical therapy, acupuncture, or chiropractic will do the trick, we will prescribe it for you.
In many cases, however, our patients have already tried most such conservative options, and in such a situation we have many different forms of Interventional Pain Management options that can work wonders. Interventional Pain Management is the medical practice of using thin needles to inject medications very accurately and specifically to the painful area(s). Such injections are image-guided, which means that we use a medical imaging device such as x-ray or ultrasound to very gently guide the needle to the painful area. In most cases, we have a specialized interventional pain management procedure developed specifically for your painful condition.
In the rare case you require surgery, we will identify that need and refer you to one of the very best surgeons in the Puget sound. Over the past decade, we have developed a network of outstanding surgeons we work closely with.
Most of our patients want to avoid opioid/narcotic pain medications as they have found they do not help, or they cannot tolerate the side effects. They have been through the process of trying them and realizing the side-effects and lack of benefit in the long term was not worth it to them. We understand this need and do our best to get our patients off of pain medications as soon as possible. We do not prescribe opioid medications due to the many negative side effects they cause. When appropriate, we do prescribe non-opioid medications that can help with pain with much fewer side-effects and virtually zero addiction potential.
Physical Therapy Prescription
Pain Psychology Referral
Massage Therapy Referral
Non-opioid Medication Prescription (we do not prescribe opioid/narcotic medications on a long-term basis)
Interventional Pain Management Procedures:
Head: greater and lesser occipital nerve block, supraorbital nerve block, infraorbital nerve block, gasserian ganglion block, sphenopalatine ganglion block, maxillary nerve block
Neck: cervical medial branch block and radiofrequency lesioning (traditional and with CerviCool cooled radiofrequency system), cervical interlaminar epidural block, cervical epidural catheter, zygapophyseal block, superficial cervical plexus block
Thorax: thoracic interlaminar epidural, thoracic transforaminal block, thoracic paravertebral block, thoracic medial branch block and radiofrequency lesioning (traditional and with ThoraCool cooled radiofrequency system), vertebroplasty, thoracic intraarticular zygapophyseal joint blocks, intercostal nerve block under fluoroscopy with contrast, intercostal neurolysis and radiofrequency lesioning
Lumbar: transforaminal epidural blocks, selective nerve root blocks, interlaminar epidural blocks, transforaminal lateral recess blocks, medial branch blocks and radiofrequency lesioning (traditional and with LumbarCool cooled radiofrequency system), intraarticular zygapophyseal joint blocks, pulsed radiofrequency of the dorsal root ganglion, pars defect blocks, hardware screw blocks, vertebroplasty, discography, functional anesthetic discography, Baylis TransDiscal cooled radiofrequency biacuplasty, percutaneous intradiscal coblation nucleoplasty, caudal epidural block, lumbar epidurolysis (Racz technique), sacroiliac joint injection and radiofrequency lesioning (traditional and Baylis SInergy cooled radiofrequency system), intradiscal ozone chemonucleolysis.
Joint Injections: shoulder joint injection, subacromial injection, olecranon bursa injection, hip injection under fluoroscopy, knee injection, trochanteric bursa injection under fluoroscopy, ischial bursa injection, knee injection, ankle joint injection, acromioclavicular joint block, pubic symphysis block under fluoroscopy, xiphisternal block under fluoroscopy
Peripheral Nerve Blocks: suprascapular nerve block and pulsed radiofrequency, median nerve block at the wrist, ulnar nerve block at the wrist, digital nerve block, axillary block with nerve stimulation and ultrasonic guidance, superficial cervical plexus block, ilioinguinal nerve block and pulsed radiofrequency, lateral femoral cutaneous block, genitofemoral nerve block, common peroneal nerve block, genital nerve block, saphenous nerve block, ankle block, pudendal nerve block, pulsed radiofrequency treatment of the pudendal nerve, radiofrequency neurotomy of the genicular nerves (traditional and Coolief cooled radiofrequency system).
Sympathetic System: stellate ganglion block, T2 and T3 thoracic sympathetic block, splanchnic block and neurolysis, celiac plexus block and neurolysis, lumbar sympathetic block and radiofrequency lesioning, hypogastric plexus block and neurolysis, ganglion impar block
Implantable Devices: spinal cord and peripheral nerve field stimulator percutaneous trial and surgical implantation, spinal cord stimulation of the conus medullaris for chronic pelvic pain, intrathecal pump trial, and surgical implantation, tunneled epidural and intrathecal catheters, continuous peripheral nerve catheters
Cryoablation Procedures of all nerves
Ultrasound guided pain procedures of all types
Prolotherapy under fluoroscopic guidance
German Neural Therapy
Orthopedic Injection Options
Fully certified by the International Orthopedics Foundation (IOF) in orthobiologic procedures to the following structures:
Knee: Intra-articular with ultrasound (supra-patellar pouch), Intra-articular with fluoroscopy, patellar tendon with ultrasound, quadriceps tendon with ultrasound, lateral compartment through patella-femoral joint with ultrasound, lateral compartment through patella-femoral joint with fluoroscopy, medial collateral ligament, meniscus, and coronal ligaments with ultrasound, lateral collateral ligament to fib head, meniscus, popliteus, biceps femoris with ultrasound, distal iliotibial band insertion with ultrasound, Baker’s cyst drainage with ultrasound, posterior medial corner structures (meniscus, pes anserine tendons, meniscus hamstrings insertions) with ultrasound, medial-lateral retinaculum and POL (posterior oblique ligament) with ultrasound, anterior cruciate ligament with ultrasound, anterior cruciate ligament with fluoroscopy, posterior cruciate ligament with ultrasound, posterior cruciate ligament with fluoroscopy, medial and lateral femoral condyle bone access, medial and lateral tibial bone access
Hip: intra-articular with fluoroscopy, intra-articular with ultrasound, labrum and hip capsular ligaments (iliofemoral, pubofemoral, ischiofemoral) with ultrasound, anterior superior and posterior facets of greater trochanter with ultrasound, proximal iliotibial band with ultrasound, posterior-lateral iliac crest muscle origins with ultrasound, anterior superior iliac spine and associated muscle origins with ultrasound, adductor group tendons with ultrasound, hamstrings origin with ultrasound, femoral nerve block, femoral bone access with fluoroscopy, acetabulum bone access with fluoroscopy, hip intra-articular hydrodilation, ligamentum teres under fluoroscopy
Shoulder: intra-articular with ultrasound, intra-articular with fluoroscopy, sub-deltoid with ultrasound, acromioclavicular joint intra-articular with ultrasound, acromioclavicular joint intra-articular with fluoroscopy, supraspinatus, infraspinatus/teres, subscapularis, biceps tendon, coracoacromio/coracoclavicular ligaments and superior glenohumeral ligament , acromioclavicular joint intra-articular, middle glenohumeral ligament/inferior glenohumeral ligament/posterior capsule with labrum, suprascapular nerve block, shoulder intra-articular hydrodilatation, humerus bone augmentation / intraosseous, superior labrum with ultrasound and fluoroscopy, Interscalene supraclavicular nerve block with ultrasound
Ankle: Ankle tibiotalar joint with ultrasound & fluoroscopy, lateral ankle ligaments (anterior talofibular ligament, calcaneofibular, posterior talofibular ligament) with ultrasound, high lateral ankle ligaments with ultrasound, peroneal tendons (longus and brevis), anterior/posterior tibialis tendon, achilles tendon, tibial nerve block, tibial nerve hydrodissection with ultrasound, deltoid ligament with ultrasound, subtalar joint injection with ultrasound, subtalar joint injection with fluoroscopy, talus bone injection with fluoroscopy, calcaneus bone injection with fluoroscopy
Foot: metatarsalphalangeal joints with ultrasound, metatarsalphalangeal joints with fluoroscopy, plantar fascia with ultrasound, plantar fascia with fluoroscopy, flexor hallucis longus with ultrasound, flexor digitorum longus with ultrasound, digital nerve block with ultrasound, dorsal capsular ligaments of metatarsalphalangeal joints with ultrasound, extensor hallucis longus with ultrasound, extensor digitorum longus with ultrasound, plantar capsular ligaments with ultrasound, plantar plate with ultrasound, sesamoid with ultrasound, talo-navicular under ultrasound, talo-navicular under fluoroscopy, calaneo-cuboid under ultrasound, calaneo-cuboid under fluoroscopy
Elbow: elbow joints with ultrasound and fluoroscopy (radiohumeral and humeroulnar), medial and lateral epicondyle with ultrasound, ulnar collateral ligament with ultrasound, radial collateral ligament/lateral collateral ligament with ultrasound, radial annular ligament, biceps insertion, triceps tendon insertion, ulnar nerve hydrodissection with ultrasound
Hand/Wrist: intercarpal with ultrasound , intercarpal with fluoroscopy, digit intra-articular (metacarpophalangeal joint, proximal interphalangeal joint, distal interphalangeal joint) with ultrasound, Digit intra-articular (metacarpophalangeal joint, proximal interphalangeal joint, distal interphalangeal joint) with fluoroscopy, carpometacarpal intra-articular with ultrasound, carpometacarpal intra-articular with fluoroscopy, carpometacarpal capsular ligaments with Ultrasound, radial, median, ulnar nerve blocks with ultrasound, digit capsular ligaments with ultrasound, flexor tendons with ultrasound, extensor pollicis brevis and abductor pollicis longus tendons with ultrasound, scapholunate ligament with ultrasound, 360 degree wrist ligaments with ultrasound, median, ulnar, radial nerve hydrodissection with ultrasound, flexor tendon sheath hydrodilatation with ultrasound, triangular fibrocartilage (TFCC) complex, RUC/DUC ligaments with ultrasound, radial collateral ligament with ultrasound
Spine: C2-C7 facets under fluoroscopy, C2-C7 facets under ultrasound, Cervical supraspinous/interspinous ligaments under ultrasound, Cervical epidurals (interlaminar or transforaminal) under fluoroscopy, greater and lesser occipital nerves under ultrasound, thoracic intra-articular facets under fluoroscopy, thoracic costovertebral facets under fluoroscopy, thoracic costovertebral facets under ultrasound, intercostal nerves under fluoroscopy, intercostal nerves under ultrasound, thoracic supraspinous/interspinous ligaments under ultrasound, lumbar facets under fluoroscopy, lumbar facets under ultrasound, lumbar supraspinous/interspinous ligaments under ultrasound, Lumbar iliolumbar ligaments under fluoroscopy, lumbar epidurals (interlaminar or transforaminal) under fluoroscopy, caudal epidural under fluoroscopy, caudal epidural under ultrasound, sacroiliac joint under fluoroscopy, sacroiliac joint ligaments under fluoroscopy, intervertebral disc injection.