Pain Management


Our facility and patient care structure provide an unparalleled environment for timely diagnosis, cutting edge treatment, and rehabilitation.
Dr. Carlos De La Hoz
Medical Director
Pain Management | Dr. Carlos De La Hoz

Pain Management :

The Neomedicine Institute utilizes a multidisciplinary approach, in which a team of health care professionals work together, to provide a full range of treatments and services for patients suffering from chronic and / or acute pain.

Interventional pain management is the “ Discipline of medicine devoted to the diagnosis and treatment of pain related disorders.” – ASIPP.

The goals of interventional pain management are to relieve, reduce, or manage pain and improve a patient’s overall quality of life through minimally invasive techniques specifically designed to diagnose and treat painful conditions.

We believe that collaboration combined with advanced technologies and techniques offer the best chance of success for our patients. By virtue of an open and transparent process, the multidisciplinary team provide a compassionate environment that helps patients’ further understand their diagnosis.

Discography is used to determine whether the intervertebral disc is the source of pain in patients with predominantly axial back or neck pain.

During discography, X-ray contrast (dye) is injected into the disc and the patient’s response to the injection is noted. If the test reproduces your typical symptom , this suggests that the disc is likely the source of the pain.

A Computed tomography (CT) is usually performed after discogram to better assess anatomical changes in the disc and to demonstrate intra-discal clefts and radial tears.

An epidural steroid injection is a common procedure to treat spinal nerve irritation that is caused by tissues next to the nerve pressing against it. The beginning of the nerve (nerve root) is most often irritated by an inflamed intervertebral disc, or disc contents, directly touching the spinal nerve.

An epidural steroid injection involves bathing an inflamed nerve root in steroids (potent anti-inflammation medicine) in order to decrease the irritation of the nerve root that is causing pain.

The Facet joints are paired joints in the back and neck, one pair at each vertebral level (one joint on each side of the vertebrae). These joints have opposing surfaces of cartilage (cushioning tissue between the bones) and a surrounding capsule that is filled with synovial fluid, which reduces the friction between bones that rub together. The facet joints can become painful due to arthritis of the spine, a back injury or mechanical stress to the back. A lumbar (lower back) facet joint injection involves injecting a steroid medication, which can anesthetize the facet joints and block the pain. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

Injections to relieve pain and provide lubrication to the joints. An alternative to cortisone can be non-steroid injections. Such as Viscosupplementation, also called Hyaluronic acid injections, are used when other treatments such as non-prescription and prescription pain relievers, physical therapy and steroid injections have proven unsuccessful or no longer effective.

Also known as (RFA) radio frequency ablation. Rhizotomy is a non surgical, minimally invasive procedure in which pain signals are “turned off” through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain.

This procedure is most commonly used to treat chronic pain and conditions such as arthritis of the spine (spondylosis) and sacroilitis. It is also used to treat neck, back, knee, pelvic and peripheral nerve pain. The benefits of radiofrequency ablation include: avoiding surgery, immediate pain relief, little to no recovery time, decreased need for pain medication, improved function, and a quicker return to work and other activities.

MIS which means minimally invasive surgery often refers to three main aspects: small incisions, fewer stitches, and less downtime. However, things can be less intrusive when talking about (MI) minimally invasive techniques in pain management, where the doctor simply uses a small needle to inject relief medication. Minimally invasive non-surgical techniques can be extremely beneficial to your recovery and overall health.

  • Trigger Point Injections: These injections temporarily numb the pain and relax the muscle, allowing for increased stretching to promote and increase blood flow.
  • Lumbar Epidural Steroid Injections: Epidural steroid infusions can be used to treat pain experienced in the lower back, neck, and mid-spine area.
  • Facet Joint Injections: A facet injection can temporarily relieve neck or back pain caused by facet joints that have become inflamed.

Percutaneous Discectomy, also knows as nucleoplasty. This is a procedure to treat a herniated disc. That’s a bulging disc in your spine. Getting rid of the bulge can relieve pressure on your nerves. It can relieve pain in your lower back and your legs.

Diagnostic spinal injections include discography (discogram), selective nerve root block (SNRB), sacroiliac joint injection and facet joint injection.

  • Facet Joint Injection – Facet joint injections involve the injection of numbing medication into the joint or around the appropriate nerves to determine if that facet joint is a pain generator. A facet joint block is an injection of local anesthetic medication into the joint.These injections are performed in the cervical, thoracic or lumbar spine under fluoroscopic guidance. If pain is relieved, it could mean that the suspected joint is the pain generator.
  • Selective Nerve Root Block (SNRB) –  A diagnostic SNRB is performed to determine if a specific spinal nerve is the source of pain. It can help to diagnose cervical, thoracic or lumbar radiculopathy (irritation and inflammation of a nerve root serving a particular body part). Under fluoroscopic (live x-ray) guidance, the specialist injects numbing medication at a specific nerve root. If the injection reduces or alleviates the patient’s symptoms, then the source of pain is located. Occasionally, the injection will need to be repeated to rule out a false-positive (placebo) response.
  • Discography – an “inside” look into the discs to determine if they are the source of a patient’s pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.
  • Diagnostic sacroiliac joint injection – Dysfunction in the sacroiliac joint is thought to cause low back and/or leg pain. The sacroiliac joint is the “chameleon” of the spine; SIJ dysfunction can mimic the pain caused by a number of other spinal structures (lumbar disc, nerve root, facet joint). The pain is typically felt on one side of the low back or buttocks, and can radiate down the leg. The pain usually remains above the knee, but at times pain can extend to the ankle or foot. Accurately diagnosing sacroiliac joint dysfunction can be difficult. A diagnosis is usually suspected by the physical examination and then confirmed with an injection under fluoroscopic (live x-ray) guidance.

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