Our Philosophy

Pain is a complex problem that requires treatment and management by a pain medicine specialist. Millions of people suffer from headaches and nerve pain at great personal cost. If you find that you cannot safely control your pain with over-the-counter medications, or have failed to find relief from other treatments or practitioners, you should consider consulting with our pain management physicians. For most patients, interventional pain management procedures can treat or reduce pain, allowing the patients to regain function, and thereby improving their quality of life.

Pudendal Nerve Block

This pudendal nerve block can be performed in several manners. Our physicians perform this procedure under fluoroscopic guidance in the procedural suite. The patient may choose to have a mild sedative or sedation before the procedure. Our physicians use a fluoroscopic unit (real time x-ray) and nerve stimulator to localize the pudendal nerve. The fluoroscopy unit is used to identify the ischial tuberosity, the pelvic landmark over which the pudendal nerve travels. Then, the physician uses a stimulating needle to localize the nerve. The stimulating needle emits a small amount of electrical current from its tip, and when the needle contacts the nerve, the patient will feel a tingling sensation in the area innervated by that branch of the pudendal nerve. Next, a small amount of local anesthetic and possibly cortisone (steroid) is injected. The local anesthetic in the injection offers a partially diagnostic component of the procedure. If the pain is reduced immediately after the procedure, then the local anesthetic portion blocked the nerve from where the pain is coming from. The steroid works as an anti-inflammatory, reduces compression and pain and can provide longer term relief. Therefore, the procedure offers both diagnostic and therapeutic value.

Numbness and pain relief identifies the pudendal nerve as the likely cause. However, the cause of pain may involve other nerves, as there are many nerves in the pelvic region. Other causes of pudenal neuralgia include:

  • Coccydynia
  • Piriformis syndrome
  • Interstitial cystitis
  • Myofascial pain / trigger points
  • Connective tissue restrictions and adverse neural tension
  • Sacroiliac joint dysfunction
  • Other spine-related pathology

Other treatable causes of pelvic pain must be ruled out by your gynecologist or urologist.

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Ilioinguinal Nerve Block

 

What is the ilioinguinal nerve?

The ilioinguinal nerve originates from the first lumbar spinal nerve. This nerve wraps above the iliac crest (upper ridge of hip bone) and travels into the groin. It provides sensation to the upper inner thigh, groin, and perineum. The perineum is between the anus and scrotum in men and between the anus and vaginal (and labia) opening in women.
Damage to the ilioinguinal nerve can be caused by surgery, trauma, and infection. Pain can be severe and be felt in the groin, testes (men), labia (women), groin, and inner thigh.

First line of treatment

Medication specifically for ilioinguinal nerve pain is the first line of therapy. These medications are similar to other drugs prescribed to treat neuropathic pain. Neuropathic pain can be caused when the nerve fibers become damaged, injured, or cannot properly function.

Nerve block

If medications do not provide good pain relief, the ilioinguinal nerve can be blocked using an injection therapy. This treatment is both diagnostic and therapeutic.
The ilioinguinal nerve block can be performed with a portable ultrasound unit, and this is the most common manner it is performed at the Spine and Pain Institute of New York. The ultrasound unit can visualize the muscles of the abdominal wall and the ilioinguinal nerve that travels between them. A small 25g needle is directed under ultrasound visualization to the nerve and the medications are injected.
Depending on injection results, future treatment can be considered, including nerve ablation (disables the nerve) and neuromodulation (pain control using spinal stimulation).

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EDUCATIONAL RESOURCES

Coccydynia

This condition is an inflammation of the tip of the tailbone, called the coccyx. It causes pain and tenderness between the buttocks.



EDUCATIONAL RESOURCES

Pudendal Neuralgia

Pudendal Neuralgia is pain in the distribution of the pudendal nerve and its branches. Pudendal neuralgia can be felt along the sit bones, along the rectum, along the perineum, and along the vaginal area, as well as the testicles and penis in males.

EDUCATIONAL RESOURCES

Celiac Plexus Block

This procedure temporarily disrupts the nerves of the celiac plexus. These nerves branch away from your spine. They connect to the organs in your abdomen. Pain signals caused by conditions such as pancreatitis or pancreatic cancer travel through these nerves on the way to your brain. A celiac plexus block can relieve your pain.



Types Of Pain

Let's live pain free.

Is Pain Management Right for You?

Depending on many factors, such as the type of pain and your general health, there are numerous options for treating your pain. Some patients are surprised to learn that a treatment that previously failed to provide relief may be effective when combined with a multi-treatment approach.

Our specialists treat complex pain issues. There are many different physical and neurological disorders that contribute to pain, and we treat all types of pain including:

HEAD & FACIAL PAINNECK PAINHAND, ARM, CHEST & SHOULDER PAINLOWER & UPPER BACK PAINPELVIC & ABDOMINAL PAINHIP, KNEE, LEG & FOOT PAINNEUROPATHYSPINAL CORD STIMULATIONCANCER PAIN
LEARN MORE ABOUT PAIN MANAGEMENT

Practice Policies

We are pleased you chose The Spine and Pain Institute of New York for the diagnosis, treatment and management of your pain. To acquaint you with our office policies, we provide the following information.

PRIOR TO PROCEDURE FORMS

*If your insurance requires a referral for a visit to a specialist, you must obtain this referral from your Primary Care Physician prior to your visit.

INITIAL CONSULTATIONS

Please bring the following relevant information to your consultation.

Photo ID
Insurance Information
Referral*
Diagnostic Studies & Reports (MRI/X-Rays)
List of Medications

INSURANCE & BILLING

We accept most insurance programs and their subsidiaries. If we do not participate in your insurance plan, please contact Billing to find out if other arrangements are possible. Text us via Klara using the messaging option to the bottom right of this page! Just detail your concern or question, and a member of the team will reply via return text message or phone call. Insurance co-payments are due at the time of arrival. We accept cash, checks and credit cards.

APPOINTMENTS

If you are a new patient, please arrive 15 minutes prior to your appointment to allow time to register. If you are running late or need to reschedule, please contact us as soon as possible to make us aware. Unfortunately, if you are more than 30 minutes late for your appointment time, we will have to reschedule.

PROCEDURES

If you are scheduled for a procedure or plan on having one in the future, please read the attached important instructions to follow prior to a procedure.You will be called prior to your procedure and notified about the following information as well.

MEDICATIONS & REFILL REQUESTS

Please discuss your medication needs, including refill requests, with your provider at the time of your appointment. Medications should be taken only as prescribed. Please do not request early refills of your medications. Patients are responsible for lost or stolen medications and prescriptions once they leave the office.

AFTER HOURS EMERGENCIES

Our regular phone lines are transferred to an answering service after normal business hours. Please proceed to the nearest emergency room for after-hours emergencies.