At the Orthopaedic Institute of Central Jersey, our Board Certified Pain Management Specialists offer a comprehensive range of non-surgical treatment options to help you minimize or eliminate chronic back or neck pain as well as neuropathic (nerve-related) conditions. Furthermore, we emphasize conservative treatment options, recommending surgery only in the event other modalities prove ineffective.
Non-Surgical Treatments We Specialize In.
What is Injection Therapy?
Injection therapy relieves spine, nerve, and muscle pain. Orthopaedic Institute of Central Jersey (OIOCJ) specialists perform many types of injections. Injections are tailored to the patient’s condition and presenting symptoms. OIOCJ specialists are fellowship trained and board certified.
Lumbar epidural injections. Treat lower back and leg pain. Steroid and anaesthetic medications are injected into the lumbar epidural space. The steroid (cortisone) reduces inflammation. The anaesthetic (Lidocaine) immediately decreases pain.
Transforaminal injections. Treat spine and extremity pain. Spinal nerve roots exit vertebrae through tiny openings called foramina. A transforaminal injection targets compressed, irritated, and inflamed nerve roots. Steroid and anaesthetic medications are injected into the transforaminal epidural space.
Lumbar sympathetic injections. Treat lower extremity pain. Anaesthetic medication is injected near pain signalling lumbar sympathetic nerves. Pain signals are blocked and pain decreases very quickly.
Stellate ganglion injections. Treat upper extremity pain. Anaesthetic medication is injected near pain signaling cervical (neck) sympathetic nerves. Pain signals are blocked and pain decreases very quickly.
Selective nerve root blocks. Treat irritated and inflamed cervical, thoracic, and lumbar nerve roots. Steroid and anaesthetic medications are injected. Pain relieve occurs quickly.
Trigger point injections. Treat muscle pain and tension. Steroid and anaesthetic medications are injected into muscle trigger points and knots. Muscles and nerves relax and pain decreases quickly.
What Conditions Does Injection Therapy Treat?
Injection therapy treats arthritis, spinal stenosis, herniated disc, sciatica, degenerative disc disease, fibromyalgia, chronic pain, and more. Scheduling and attending an initial OIOCJ consultation is the first step toward receiving an injection therapy solution. A complete medical history will be obtained, a physical examination will be performed, medical imaging tests will be ordered and analyzed. An accurate diagnosis will be made. A customized injection therapy treatment plan will be created. To schedule your appointment with an OIOCJ specialist, call 732-201-6990 or visit our contact page.
Sacroiliac Joint Injections
What are Sacroiliac Joint Injections?
The SI joints connect the spine to the hips. The SI joints are shock absorbers that bear the weight of the entire upper body. The SI joints can be irritated and inflamed due to injury, overuse, or ageing processes.
SI joint injections may be diagnostic or therapeutic. The patient rests comfortably on their stomach. The skin is sterilized. A local anaesthetic is given to ensure no pain or discomfort is felt. Using fluoroscopic x-ray guidance, a needle is directed into the SI joint. Once the needle is in a perfect position, anaesthetic and corticosteroid medications are injected. The anaesthetic quickly decreases pain. The corticosteroid decreases inflammation.
What Condition Does Sacroiliac Joint Injections Treat?
Orthopaedic Institute of Central Jersey specialists uses SI joint injections to diagnose SI dysfunction. If the patient experiences immediate pain relief after an SI injection, SI dysfunction is diagnosed and effective treatment options are prescribed. Treatment plans usually include a variety of treatment options. Corticosteroids are given during the SI injection reduce inflammation. Physical therapy strengthens and stretches important back hip, and leg muscles. A brace, oral nonsteroidal anti-inflammatory drugs (NSAIDs), rest, ice, and activity modification are also commonly included in an OICJ specialist’s treatment plan.
Patients’ lives should not be dictated by SI joint pain. OIOCJ specialists are fellowship trained and board-certified. They obtain a medical history review, perform a physical examination, and order and analyze medical imaging studies to accurately diagnosis SI joint dysfunction. As previously mentioned, SI joint injections may be used as a diagnostic test and/or a treatment option. To schedule your appointment with an OIOCJ specialist, call 732-201-6990 or visit our contact page.
Spinal Cord Stimulator
What is a Spinal Cord Stimulator?
A spinal cord stimulator (SCS) is a device that is implanted in the spine. The stimulator sends electric impulses that block pain signalling nerves. An SCS treats chronic back and extremity pain. An SCS is an alternative to surgery and long-term pain medication use.
Orthopaedic Institute of Central Jersey specialists perform SCS procedures. Specialists are fellowship trained and board certified. The newest and most effective procedure techniques and devices are used. A successful procedure and pain relief are ensured. The procedure consists of two parts: a trial and an SCS implantation.
A trial procedure. Used to determine if an SCS will benefit the patient. An electrode is placed in the epidural space. Impulses are sent to the electrode. The patient provides the OICJ specialist with sensation feedback. The electrode is placed in a position where it provides maximum pain relief. Pain is monitored for one week. If pain improves, an SCS implantation is recommended.
SCS implantation. Used to place the SCS in the patient. IV sedation ensures no pain or discomfort is felt. The patient rests comfortably on their stomach. A small lower back incision is made. Two electrode wires are placed in the epidural space. A lower waistline incision is made and a small pocket is created. The SCS is placed in the small pocket. The leads are attached to the SCS. The SCS is programmed perfectly. Incisions are closed.
The patient receives special SCS instructions. The patient returns home shortly after the procedure. Restrictions ensure the electrodes do not move. The patient returns to OICJ 7-10 days after the procedure to have their stitches removed.
What Conditions Does a Spinal Cord Stimulator Treat?
OIOCJ specialists have used an SCS to improve countless lives. An SCS is especially effective at treating:
- Chronic neck or back pain
- Complex regional pain syndrome (CRPS)
- Reflex sympathetic dystrophy (RSD)
- Refractory angina
- Failed neck or back surgery
Scheduling and attending an initial OIOCJ consultation is the first step in the treatment process. During an initial consultation, an OIOCJ specialist obtains a medical history, performs a physical exam, and orders and analyzes medical imaging studies. To schedule your appointment with an OIOCJ specialist, call 732-201-6990 or visit our contact page.
Facet Joint Injections
What are Facet Joint Injections?
Facet joint osteoarthritis. The facet joints move the spine. A normal facet joint is covered in healthy cartilage. An osteoarthritic facet joint has damaged cartilage. Pain is caused when the joint moves.
Treatment options. Non-surgical treatment options treat mild to moderate facet joint osteoarthritis. Minimally invasive treatment options treat severe facet joint arthritis and facet joint arthritis that is unresponsive to non-surgical treatment. Facet joint injections are an effective minimally invasive treatment option.
The procedure. A mild sedative and local anaesthetic ensure no pain or discomfort is felt during the procedure. The patient rests comfortably on their stomach. Fluoroscopic X-ray guidance is used. A needle is gently guided to the pain causing facet joint. Anaesthetic and corticosteroid medications are injected into the joint. A dressing is placed over the needle mark.
Results. The anaesthetic medication provides immediate pain relief. The steroid medication decreases inflammation. Other treatment options are used in conjunction with injections for maximum pain relief. Physical therapy, activity modification, bracing, medications, and more are commonly included in an OIOCJ specialist’s customized facet joint osteoarthritis treatment plan.
An initial consultation. Orthopaedic Institute of Central Jersey (OIOCJ) specialists perform facet joint injections. Specialists are fellowship trained and board-certified. Injection techniques have been perfected. Pain relief is ensured. First, a medical history review is obtained. Next, a physical examination is performed. Last, medical imaging tests are ordered and analyzed. An accurate diagnosis is made and a customized treatment plan is created. To schedule your appointment with an OIOCJ specialist, call 732-201-6990 or visit our contact page.
What is Radiofrequency Ablation?
Radiofrequency ablation. An electric current heats a pain signal producing nerve. Pain signals to the brain are blocked. The patient experiences significant pain relief.
The procedure. IV sedation and a local anaesthetic ensure no pain or discomfort is felt. Fluoroscopic X-ray guidance is used. A tiny needled is guided to a specific nerve. A microelectrode is inserted through the needle. The patient gives pain sensation feedback. After the microelectrode is perfectly positioned, a radiofrequency current is sent through and the nerve is heated.
Recovery and results. The patient returns home shortly after the procedure. There is little to no recovery time. The patient returns to work and normal activities quickly. Pain relief is sometimes experienced immediately. Pain relief lasts six months to many years.
What Conditions Does Radiofrequency Ablation Treat?
Radiofrequency ablation treats chronic neck, back, and sacroiliac pain. Radiofrequency ablation is an alternative to open surgery and long-term pain medication use.
Orthopaedic Institute of Central Jersey specialists are radiofrequency ablation experts. Specialists are fellowship trained and board certified. They obtain a medical history, perform a physical examination and order and analyze medical imaging studies. An accurate diagnosis is made. A diagnostic injection is usually performed before radiofrequency ablation to ensure the treatment will benefit the patient. To schedule your appointment with an OIOCJ specialist, call 732-201-6990 or visit our contact page.
Recent Success Stories
Dear Dr. Bhatnagar,
Thank you for taking such wonderful care of me. You are not only a great surgeon but a very kind and patient man.
With lots of appreciation,
I want to thank Dr. Goldstein for truly understanding my condition and helping me. I received an epidural injection that Dr. Goldstein administered personally. His thorough notes during my initial visit facilitated a precise injection and my pain condition has improved exponentially as a result.Patient Review
Dr. Lospinuso made me feel like I was the only patient he had. He explained my problem: no rushing, easy to understand language & artwork of my problem. I would highly recommend him to my family & friends.Patient Review