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.

Hand, Arm, Chest & Shoulder Pain
Conditions & Treatment Options

Joint pain is common, and it can be caused by osteoarthritis of aging, trauma, or inflammatory conditions like Rheumatoid arthritis. If you have tried hot and cold packs, physical therapy, and medications but find yourself still struggling with pain, it may be time to consider the next level of therapy with an image-guided joint injection.

Synthetic steroids are similar to the natural steroidal hormones that are produced by the body. Steroids help to reduce inflammation from arthritis which in turn can reduce pain and swelling for several months at a time. Steroid injections can be performed for pain in almost any joint and be repeated if necessary.

Hyaluronic acid injections are also referred to as gel injections because of the thick lubricating consistency of the medication. Arthritis and age cause the natural cushion of the knee joint to wear down. Gel injections are performed in a series and help to replace that cushion providing pain relief for up to 12 months.

Platelet rich plasma, or PRP, injections are a form of Regenerative Medicine that harnesses the healing power of your own body to improve pain. A small amount of your own blood is taken to prepare an injection that is rich in platelets. Platelets contain clotting factors and growth factors which promote healing of joints, ligaments, and tissues. PRP is most effective when it is performed as a series of injections. These injections can relieve pain for months, years, or even indefinitely.

Peripheral Neuropathy

Neuropathy is the medical term for nerve damage. A generalized type of neuropathy, known as polyneuropathy, is the most common type of peripheral neuropathy. Signs and symptoms of peripheral neuropathy include loss of sensation and/or burning pain in the hands or feet. Treatments for peripheral neuropathy are available and include several elements: diet and exercise, control of blood glucose levels for diabetics, prevention of injury, and control of painful symptoms.

LEARN MORE ABOUT Neuropathy

Intercostal Neuralgia/Chest wall pain

Pain can come from the rib cage be coming from several sources. When pain arises from the nerves in the chest, it typically comes from the intercostal nerves. The intercostal nerves arise from the spinal cord and lie under the rib, along with the vein and artery. These nerves innervate the muscles of the rib cage and the skin and chest cavity. The intercostals nerves can be injured in from surgery or trauma, viral infections such as shingles, or idiopathic (no identifiable cause).

Procedure
The appropriate location in the rib cage is located under fluoroscopy (real time x-ray) in the procedural suite. An IV is usually placed and a light anesthetic (twilight) may be administered if needed beforehand.

After sterile prep of the area, a small needle (25g) is advanced carefully to the inferior border of the rib under fluoroscopic guidance. The needle is then walked off the rib to lie immediately below the rib. The vein, artery, and nerve lie underneath the inferior portion of the rib. A small amount of contast material is then injected and the structures should be outlined. A small amount of local anesthetic and steroid is then injected into the space to block the nerve.

This injection is both potentially diagnostic and therapeutic, in that if the pain resolves with the local anesthetic then we know the correct nerve was blocked. The steroid component may provide longer term relief. If the underlying condition does not improve over time with the assistance of this injection, then the pain may return.
If the pain recurs, there are other procedures that can be considered for longer term relief such as a pulsed radiofrequency ablation of the nerve root or spinal cord stimulation or dorsal root ganglion stimulation to control the pain.

The procedure is not relatively painful. There is a small risk of pneumothorax (puncture of the lung) with this procedure and systemic absorption of the local anesthetic, which is real and must be taken into consideration when deciding whether or not to proceed with the injection.

SHOULDER & ARM RESOURCES

Shoulder Joint Injection

This injection treats the pain of an inflamed nerve in your cervical spine. It relieves nerve swelling. If you have a herniated disc, spinal stenosis or some other problem that's pressing on a nerve, it may help you.





SHOULDER & ARM RESOURCES

Trigger Point Injections

This injection treats the pain of an inflamed nerve in your cervical spine. It relieves nerve swelling. If you have a herniated disc, spinal stenosis or some other problem that's pressing on a nerve, it may help you.

SHOULDER & ARM RESOURCES

PRP Therapy

This injection treats the pain of an inflamed nerve in your cervical spine. It relieves nerve swelling. If you have a herniated disc, spinal stenosis or some other problem that's pressing on a nerve, it may help you.





WRIST & HAND RESOURCES

Carpal Tunnel Syndrome

This injection treats the pain of an inflamed nerve in your cervical spine. It relieves nerve swelling. If you have a herniated disc, spinal stenosis or some other problem that's pressing on a nerve, it may help you.

WRIST & ARM RESOURCES

Peripheral Neuropathy

This injection treats the pain of an inflamed nerve in your cervical spine. It relieves nerve swelling. If you have a herniated disc, spinal stenosis or some other problem that's pressing on a nerve, it may help you.



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.