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Nerve Blocks


Medial Branch Blocks

Medial Branch Blocks are a type of diagnostic and therapeutic procedure used to treat and evaluate facet joint pain in the spine. A medial branch block involves the injection of a local anesthetic (and sometimes a steroid) near the medial branch nerves. These nerves provide sensation to the facet joints in the spine, which can cause pain if they become irritated or inflamed. The goal of the block is to temporarily "numb" these nerves and provide pain relief. Medial Branch Blocks are performed in the cervical, thoracic, and lumbar regions of the spine.

 

Radiofrequency Ablations

If a medial branch block provides good pain relief, a more semi-permanent solution known as radiofrequency ablation (RFA) may be offered.Radiofrequency Ablation (RFA) is a minimally invasive procedure used to reduce pain by using heat generated from radiofrequency waves to destroy the tissue surrounding specific nerves that are transmitting pain signals to the brain. It is commonly used for treating chronic pain conditions, particularly those affecting the spine, joints, and soft tissues. RFA is considered a long-term solution to pain management (often lasting 6–12 months or more) and may be repeated as needed.

 

Genicular Nerve Block

A Genicular Nerve Block is a minimally invasive procedure used to treat knee pain, particularly pain that arises from osteoarthritis (OA), inflammation, or other joint-related conditions. The procedure targets the genicular nerves, which are sensory nerves that provide pain sensation to the knee joint. By blocking these nerves, the procedure can provide significant pain relief. It can also serve as a diagnostic tool to identify the genicular nerves as the source of pain. For those who experience significant relief, the procedure can lead to further treatment options, such as radiofrequency ablation, for more long-term pain management.

 

Genicular Radiofrequency Ablations

Genicular Radiofrequency Ablation (RFA) is a minimally invasive procedure used to provide long-term pain relief for patients suffering from chronic knee pain, particularly pain associated with osteoarthritis (OA), inflammation, or joint degeneration. The procedure involves using radiofrequency (RF) energy to target and destroy the genicular nerves that are transmitting pain signals from the knee joint to the brain. By disrupting these nerve signals, genicular RFA helps alleviate pain and improve function in the knee.

 

Lumbar Sympathetic Block

A Lumbar Sympathetic Block is a medical procedure used to treat certain types of chronic pain conditions that are related to the sympathetic nervous system in the lower back and legs. The procedure involves injecting a local anesthetic, sometimes combined with a steroid, near the sympathetic nerves in the lumbar (lower back) region to block pain signals and reduce inflammation. This can provide relief for conditions such as complex regional pain syndrome (CRPS), vascular disease, and certain types of chronic lower back pain. 

 

Intercostal Nerve Block

An Intercostal Nerve Block is a medical procedure in which an anesthetic (and sometimes a steroid) is injected near the intercostal nerves, which are the nerves that run between the ribs. This block is primarily used to treat pain that originates from the chest or rib cage area, including conditions such as rib fractures, post-surgical pain, and certain types of chronic pain syndromes. By blocking the intercostal nerves, this procedure helps to interrupt pain signals from the chest wall and provides pain relief.

 

Stellate Ganglion Block

A Stellate Ganglion Block (SGB) is a procedure used to treat various types of chronic pain and certain autonomic dysfunctions by targeting the stellate ganglion, which is a collection of nerves located in the neck usually near C6 and C7 vertebrae. By injecting a local anesthetic (sometimes with steroids) into or near this ganglion, the procedure helps block nerve signals, providing relief for specific conditions that involve sympathetic nerve dysfunction.

 

Cluneal Nerve Block

A Cluneal Nerve Block is a medical procedure used to provide pain relief by targeting the cluneal nerves, which are sensory nerves that supply sensation to the skin in the lower back, hips, and upper thighs. The cluneal nerves can sometimes become irritated or compressed, leading to pain or discomfort in these areas. The procedure involves injecting a local anesthetic, and sometimes a steroid, around the cluneal nerve to block pain signals and provide relief from conditions that cause pain in these regions. 

 

Transversus Abdominis Plane (TAP) Block

The TAP block involves the injection of a local anesthetic into the transversus abdominis plane, a potential space between the transversus abdominis muscle and the internal oblique muscle. Ultrasound is commonly used for real-time visualization of the needle placement to ensure that the anesthetic is deposited in the correct space. By blocking these nerves, the TAP block provides analgesia to the abdominal wall, reducing pain. Indications for a TAP Block are abdominal surgeries, trauma, and chronic pain.  

 

Femoral Cutaneous Nerve Block

A Femoral Cutaneous Nerve Block is a regional anesthesia technique that targets the femoral cutaneous nerve, a sensory nerve that provides sensation to the skin over the anterior (front) and medial (inner) aspects of the thigh. This block is typically used for pain management in various medical conditions or procedures involving the thigh area. Indications for a femoral cutaneous nerve block are post-operative pain management after surgeries, chronic pain, trauma, and diagnostic purposes.  

 

Sphenopalatine Ganglion Block

The sphenopalatine ganglion block (nasal approach) is a highly effective, non-invasive procedure used to treat a variety of headaches and facial pain syndromes, such as cluster headaches and migraines. It provides rapid relief with minimal side effects, making it a valuable treatment option for patients who suffer from severe, recurrent pain. 

 

Ganglion Impar Block

The Ganglion Impar block is a medical procedure used to treat pelvic pain that arises from the perineal region and pelvic organs. By blocking the ganglion impar, the procedure can help alleviate pain related to various conditions that affect the pelvic region, such as chronic pelvic pain, perineal pain, cancer pain, or pain related to conditions like hemorrhoids and prostatitis. 

Head and Face


Migraine Treatment

A migraine headache is a form of a headache that is often severe and accompanied by other symptoms such as sensitivity to light and sound and nausea or vomiting. At times, a migraine is described as an intense throbbing or pulsing pain. It is common for a migraine to be felt on only one side of the head.

 

Trigeminal Neurolagia

Trigeminal Neuralgia is due to irritation of the trigeminal nerve located on the face. This condition causes brief, but extreme episodes of shooting pain. If you’re suffering from severe, chronic pain of this category due to trigeminal neuralgia and seeking relief, the pain specialists at Cleaver Medical Group can help. 

 

Dystonias 

Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements. The condition can affect one part of your body (focal dystonia), two or more adjacent parts (segmental dystonia) or all parts of your body (general dystonia).

Extremity Pain


Complex Regional Pain 

Formerly referred to as Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by severe burning pain, most often affecting one or more of the extremities. CRPS most often occurs after an injury or severe physical strain such as a stroke or heart attack. If you’re struggling with CRPS following one of these events, there is help. 

 

Suprascapular Pain and Neuropathy

Suprascapular neuropathy is caused by a compression of the suprascapular nerve, a motor nerve that controls two of the main muscles in the shoulder blade. This condition results in shoulder instability, which can make it difficult to perform simple tasks and live life the way you enjoy it. If left untreated, suprascapular neuropathy can lead to more severe problems.

 

Hip, Knee, Shoulder Osteoarthritis

Osteoarthritis, also known as OA or degenerative joint disease, occurs when the cartilage that is located at the end of the bone begins to wear down. This form of chronic arthritis is one of the most common conditions of the joints and can appear in any joint, although it is commonly found in the knee, hips, lower back, neck, and smaller joints of the fingers and toes. 

 

Peripheral Neuropathy

Neuropathy is severe pain that is the result of a damaged nerve. Although it is possible to obtain a damaged nerve anywhere in the body, peripheral neuropathy often affects the feet. The cause of this condition is often unknown, although at times it can be the result of an underlying medical condition; those living with diabetes are particularly susceptible. 

 

Piriformis Syndrome

Piriformis syndrome is a condition caused by irritation of the sciatic nerve. Most patients who are diagnosed with piriformis syndrome experience pain or numbness that radiates the length of the nerve, from the buttocks down through the legs. 

 

Phantom Limb Pain 

Phantom limb pain, or PLP, refers to ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone, however the pain is real. The onset of this pain most often occurs soon after an amputation procedure has been performed.

Injections


Epidural Steroid Injections

An epidural steroid injection (ESI) is a medical procedure in which a corticosteroid (a type of anti-inflammatory medication) is injected into the epidural space of the spine. The epidural space is the area surrounding the spinal cord and nerve roots. The purpose of this injection is to reduce inflammation and swelling, which can help alleviate pain, especially in cases of conditions like herniated discs, spinal stenosis, sciatica, or radiculopathy. This can be done in the cervical, thoracic, lumbar, and caudal regions of the spine.

 

Sacroiliac Joint injection

A sacroiliac (SI) joint injection is a medical procedure where a local anesthetic and corticosteroid is injected into the sacroiliac joint, located at the junction where the sacrum (the triangular bone at the base of the spine) meets the iliac bones of the pelvis. This joint plays a crucial role in absorbing shock and stabilizing the pelvis. When there's inflammation or dysfunction in the SI joint, it can cause pain in the lower back, buttocks, and legs. 

 

Trigger Point Injections

A trigger point injection (TPI) is a medical procedure used to treat painful areas of muscle tissue known as "trigger points." These are tight knots of muscle fibers that can develop when a muscle is overworked, injured, or stressed. Trigger points can cause localized pain, as well as referred pain (pain felt in other areas of the body). The injection typically contains a combination of a local anesthetic (to relieve pain) and a corticosteroid (to reduce inflammation), and is aimed at relaxing the affected muscle and providing pain relief. 

 

Lumbar Transforaminal Epidural Steroid Injections

A Lumbar Transforaminal Epidural Steroid Injection (TFESI) is a medical procedure used to treat pain in the lower back and legs caused by inflammation around the spinal nerve roots. Transforaminal refers to the method of delivering the medication into the epidural space through a specific path — the foramen, which is the opening where the nerve roots exit the spine. The procedure involves injecting a combination of corticosteroid (to reduce inflammation) and a local anesthetic (to provide immediate pain relief) into the epidural space near the affected nerve root. It’s typically used to treat conditions like lumbar radiculopathy, sciatica, herniated discs, or spinal stenosis.  

 

Platelet-Rich Plasma Injections

Platelet-Rich Plasma (PRP) Injections are a form of regenerative medicine used to promote healing and reduce pain, particularly in musculoskeletal conditions like tendon injuries, arthritis, and soft tissue damage. The treatment involves using a person’s own blood to create a concentrated mixture of platelets, which are rich in growth factors that promote tissue repair and regeneration.  

 

Botox Injections for Migraines

Botox has been FDA-approved for the treatment of chronic migraines in adults who experience headaches for 15 or more days a month, with at least 8 of those days involving migraines. It’s used as a preventive treatment to reduce the frequency and severity of migraines. These injections may prevent the activation of migraine-associated nerves and reduce inflammation around the nerves. Botox is injected into 31 sites around the head and neck every 12 weeks.  

 

Botox Injections for Dystonia

Botox has been shown to be an effective treatment for various forms of dystonia, such as cervical dystonia (also called spasmodic torticollis), blepharospasm (eye twitching), and limb dystonia. Botox works by temporarily paralyzing the overactive muscles responsible for the abnormal movements and postures. By blocking the release of acetylcholine, Botox reduces the muscle contractions that cause the involuntary movements or spasms. This procedure can be performed every 8-12 weeks.  

 

Intra-Articular Steroid Injections

Intra-articular injections are a type of medical procedure in which a substance is injected directly into the joint to relieve pain, reduce inflammation, or promote healing. The injection typically contains a combination of a local anesthetic (to relieve pain) and a corticosteroid (to reduce inflammation). These injections are often used to treat conditions such as osteoarthritis, rheumatoid arthritis, and other joint-related issues. Common joints treated with this injection include: knees, hips, shoulders, elbows, and ankles  

 

Zilretta Knee Injections

Zilretta is an FDA-approved injectable medication used for the treatment of osteoarthritis (OA) pain, specifically for knee osteoarthritis. It is a brand name for triamcinolone acetonide, a type of corticosteroid that is formulated in a way that allows for sustained release. Zilretta provides longer-lasting pain relief compared to traditional steroid injections. This injection can be performed every 12 weeks.  

 

Greater Trochanteric Bursa Injections

A Greater Trochanteric Bursa injection is a medical procedure where medication is injected directly into the bursa located near the greater trochanter of the femur (thigh bone) to relieve pain and inflammation associated with conditions like trochanteric bursitis or other hip-related issues.The injection typically contains a combination of a local anesthetic (to relieve pain) and a corticosteroid (to reduce inflammation).  

Pain Management Providers


MIRANDA REED CLEAVER, D.O.

MIRANDA REED CLEAVER D.O.

Miranda Reed Cleaver, D.O. is a Georgia native. She grew up in Chatsworth, Georgia and attended the University of Georgia in Athens. She graduated from the University of Georgia with a Bachelor of Science in Biology in 2006. After college, Dr. Cleaver continued her education and attended medical school at the Philadelphia College of Osteopathic Medicine, Georgia Campus located in Suwanee, Georgia. She then went on to complete her four years of training in Anesthesiology at McLaren Oakland Hospital, part of the Michigan State University Statewide Campus System, in Pontiac, Michigan, a suburb of Detroit. Following the completion of her residency training, Dr. Cleaver then completed her Fellowship in Pain Management at McLaren Oakland Hospital, part of the Michigan State University Statewide Campus System, in Pontiac, Michigan.

During her fellowship training, she performed numerous interventional procedures in all areas of pain management. Once her training was complete, Dr. Cleaver then went on to establish a pain management practice for two hospitals located in Northern Missouri. Despite a thriving practice, Dr. Cleaver always wanted to make it back to her home state, thus inspiring the creation of the Cleaver Medical Group based in Cumming, Georgia. Her professional interests include low back pain, cervical pain, complex regional pain syndrome, thoracic pain, knee and shoulder pain, discogenic pain, osteoarthritis, and spinal cord stimulators.

Her main reason for pursuing a pain management fellowship was to help alleviate the chronic pain and improve the quality of life of many of the patients that she saw in the hospital on a daily basis. She cannot promise a pain free life, but certainly will reduce the overall pain burden, and help improve the patient’s quality of life. Her main goal is to get each and every patient back to their previous daily functioning and activities. She has always been a bulldog at heart, whose main hobbies include spending time with family cheering on the University of Georgia Bulldogs.

COLIN KRESS, D.O.

COLIN KRESS, D.O.

Dr. Kress attended Oglethorpe University where he received his bachelor’s degree in Biopsychology and Chemistry. He completed his medical degree at Lincoln Memorial University-DeBusk College of Osteopathic Medicine in 2014 and subsequently completed his Anesthesia Residency and Pain Management Fellowship at Michigan State University McLaren Oakland Hospital.

Clinical interests include:

  • Medication Management

  • Interventional Pain Procedures

LIZ SIPPLE, NP-C

LIZ SIPPLE, NP-C

Liz Sipple, NP-C is a board certified Nurse Practitioner who joined Cleaver Medical Group in November 2017. You might recognize her from all her work in the procedure room. Liz was born in a small town in Vermont, but moved around until she landed in Georgia. She graduated Magna Cum Laude from Brenau University in 2013 with her Bachelor's of Science in Nursing. She later graduated Summa Cum Laude from Brenau University with her Master's of Science Family Nurse Practitioner Degree. Liz has worked a wide variety of places including Medical Surgical hospital units, Short Stay surgical units, and more recently as a provider at an Urgent Care.

Liz enjoys spending time with her husband and family, running, and being outdoors with her two chocolate labs Lucy and Maggie. 

Medication Management


Medication Management

Unfortunately all medications can have deleterious side effects on the human body. That is why at Cleaver Medical Group we make every effort possible to optimize treatment of the underlying cause of pain, while minimizing the risks to our patients. Our pain management services are currently offered at our Cumming location.

Chronic pain is pain that has persisted for greater than a three month time period. This type of pain can be related to:

  • Previous injuries

  • Underlying medical conditions

  • Cancerous pain causing damage to the body.

The aim of medication management in the treatment of chronic pain is to provide symptomatic relief and to help progressively increase an individual’s daily level of functioning and activities. Due to advances in modern medicine over the years, there are now many types of safe and effective medications that can help with just this. Medications used depend on the type of chronic pain that each patient is experiencing and can be non-narcotic and narcotic in nature. Some examples of medication classes that are non-narcotic include:

  • Non-steroidal anti-inflammatories
  • Anti-depressants
  • Acetaminophens
  • Muscle relaxants
  • Anti-convulsants
 

Do you prescribe Suboxone ?

Our practice does not offer Suboxone.

Do you require a referral or can I just call to make an appointment?

New patients typically need to be referred by a primary care physician or other specialist. If you feel you would benefit from our services, ask your physician for a referral or contact our center and we may be able to assist you in obtaining a referral from your provider.

What happens at the first appointment?

At this appointment you will meet with one of our practitioners for a comprehensive exam, where a personalized treatment plan will be developed for you.

*Please be aware that our providers do not prescribe controlled substances at your first visit, and any medication refills you need in the meantime would need to be coordinated with your prescriber.

My previous provider said she/he will not prescribe any more medication. What do I do now?

1) Talk with your previous provider about how to safely taper your medications.

2) If you are already out of medication, talk with them about managing withdrawal symptoms.

3) Unfortunately we cannot take over your prescription medications in an urgent situation like this.

  • Do you prescribe opioid pain medications?

    Opioids can be part of a treatment regimen, but often certain types of pain are not well treated with them and because of their safety profile they are often not the best option in the long term.

Other than opioid medications, how could my pain be managed?"

The good news is that medication is only one part of effective pain management. A combination of approaches is often the best way to manage your pain. Our practice uses a multidisciplinary approach to treating pain. The whole focus of multidisciplinary programs is to get people functioning again. One of the drawbacks of long-term opiate use is many people who take these drugs over a long period of time lose physical function. The goal is to restore physical function and to help people learn that chronic pain does not have to prevent them from living a full, active life.

Will my pain get worse if I am very active?

When you have constant pain it seems natural to avoid doing things like walking, bending and moving around as they can make the feeling of pain worse. However our bodies are designed to move. When we decrease activity, we lose muscle strength – over time this means that even simple daily activities can become more difficult. Many people with pain fear exercise as they think it will cause more problems. However, regular stretching and exercise can actually decrease pain and increase your ability to function physically.

It is important to remember that chronic pain is not necessarily associated with ongoing damage to your body. This means that hurt doesn’t necessarily equal harm, and if no ongoing cause for the pain is found, you can slowly increase your physical activity despite a certain level of pain. This gradual approach to activity is called pacing.

Should I wait for my pain to go away before I go back to activities I used to do?

Starting to exercise and learning new coping skills are important strategies to help improve your ability to function and reduce the impact of the pain. It is also important not to wait for the pain to be completely gone before starting normal activities, including work.

I want to stop opioids, but I don’t know how, and I’m worried about withdrawal."

Withdrawal is a common effect of stopping opioids. It is uncomfortable but not life threatening and there are strategies to minimize this and help treat the symptoms.

I’ve been told that there is a difference between physical dependence and addiction to pain medications, but I don’t understand. Can you explain the difference to me?"

Physical dependence occurs with any person that takes narcotics at a certain dose for a time, if the medication is stopped abruptly then there may be withdrawal symptoms such as nausea, diarrhea, feeling shaky and sweaty.

Addiction occurs in susceptible individuals, and there are ways to figure out who may be more susceptible. This may manifest as a craving for the medication and may include escalating dosages and drug seeking behavior.

Interventional Procedures


Interventional Procedures

Pain is an unfortunate part of everyday life for some people and is commonly defined as physical suffering or discomfort caused by an illness or an injury. Pain can be very extensive and multifactorial in nature lending its cause due to previous injury or a variety of underlying medical disorders either cancerous or non-cancerous in character. This is where a Pain Management physician can be of help.

Pain Management physicians can help alleviate daily chronic pain through multiple modalities including, but not limited to, injections and medication management. Each patient is different and therefore each type of pain is different. This is why at Cleaver Medical Group, we believe in a well-balanced and safe approach to effectively help treat and alleviate each patient’s pain. Our pain management services are offered at our Cumming, Dahlonega, and Dawsonville locations.

 

EPIDURAL INJECTIONS

EPIDURAL INJECTIONS

Patients will find the comfort using an epidural steroid injection, which include a reduction in pain radicular pain. Patients seem to have a quick, better and positive response when the epidural steroid injections are coupled with an organized therapeutic exercise program.

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NEUROMODULATION INCLUDING SPINAL CORD STIMULATORS & PUMP REFILLS

NEUROMODULATION INCLUDING SPINAL CORD STIMULATORS & PUMP REFILLS

Neuromodulation including spinal cord stimulators & pump refills treatments that involve stimulation or administration of medications directly to the body’s nervous system for therapeutic purposes. Neuromodulation can be utilized to treat movement disorders, and epilepsy, as well as pain conditions.

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OCCIPITAL/SUPRAORBITAL NERVE INJECTIONS

OCCIPITAL/SUPRAORBITAL NERVE INJECTIONS

The supraorbital nerve runs through the bones of the face at the eyebrow, provide sensation to the temple and the acme of the head. The nerve exits the head just higher than the eyes. Supraorbital Nerve Injections obstruct for Migraine and Headache.

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SYMPATHETIC NERVE BLOCK

SYMPATHETIC NERVE BLOCK

A Sympathetic nerve block usually involves a sequence of injections to relieve pain caused by complex regional pain syndromes, usually after injury to a joint. This nerve block can be used to treat pain relating the nerves of the sympathetic nervous system. If you have pain in the higher part of your body then you may get pain relief from blocking the ganglion in your neck area. 

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CELIAC/SPLANCHNIC NERVE BLOCKS

CELIAC/SPLANCHNIC NERVE BLOCKS

The celiac plexus obstruct and the splanchnic nerve block can be used for abdominal soreness that may be caused by exasperation, firmness or setup of the nerve bundles inside various abdominal organs, as well as owing to tumor invasion, fibrosis, or chronic tenderness resultant from chronic pancreatitis disease, along with others.

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DIAGNOSTIC NERVE BLOCKS

DIAGNOSTIC NERVE BLOCKS

Nerve blocks are used for pain treatment and administration. A Diagnostic Nerve Block involves deadening a specific nerve or group of nerves that may be concerned in taking a patient’s pain. If a particular pain-carrying nerve is insensitive and a patient notes significant improvement in pain symptoms, the location of the pain generator is likely confirmed.

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SACROILIAC JOINT INJECTION

SACROILIAC JOINT INJECTION

A sacroiliac joint inoculation moreover called a sacroiliac joint block—is largely used either to make a diagnosis or take care of low back pain and/or sciatica symptoms related with sacroiliac joint dysfunction. The sacroiliac joints stretch out subsequently to the spine and unite the sacrum with the hip on both sides.

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TRIGGER POINT INJECTIONS

TRIGGER POINT INJECTIONS

Trigger point injection (TPI) might be an alternative for treating soreness in various patients. TPI is a practice used to treat throbbing areas of muscle that have trigger points, or knots of muscle to facilitate when muscles do not unwind. Numerous times, such knots can be felt below the skin.

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MEDIAL BRANCH BLOCKS

MEDIAL BRANCH BLOCKS

Medial branch blocks can be used independently to provide long-term pain relief. They can also be used to precisely identify the facet joints as the cause of pain, and are the preliminary procedure prior to radiofrequency neurotomy of the medial branch nerves. Medial branch blocks have been performed safely for many years with excellent outcomes.

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RADIOFREQUENCY ABLATIONS

RADIOFREQUENCY ABLATIONS

In Radiofrequency (rhizotomy) ablations procedure, a heat lesion is created on certain nerves with the goal of interrupting the pain signals to the brain, thus eliminating pain. The terms radiofrequency ablation and radiofrequency neurotomy are used interchangeably. Both terms refer to a procedure that destroys the functionality of the nerve using radiofrequency energy.

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CRYOABLATION

CRYOABLATION

According to the Clavien-Dindo classification, five grade II complications and four grade complications occurred. The technical success rate was 94%. Two tumors required a second session of cryoablation because of recurrence or residual tumor.

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DISCOGRAM

DISCOGRAM

The indications for getting a discogram prior to a lumbar fusion surgery are extremely variable amongst spine surgeons. Ordering the procedure depends on access to a skilled discographer. A discogram is basically a very subjective test, and if there are no experienced discographers available, then the spine surgeon may forego the test since a poorly done discogram does not yield any useful information.

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About Your Appointment


Appointments

We ask that all new patients and anyone with a change of insurance arrive 30 minutes before your scheduled appointment time. Established patients please arrive 15 minutes before your scheduled appointment time. This will ensure that your check-in process is completed thoroughly and will allow you to maximize your time with the provider.

Please bring a photo ID and current updated insurance card with you to each visit. For your convenience, when you make an appointment over the phone, you will be given the option of creating an online account using our patient portal. Please utilize the patient portal to complete as much information as possible before you arrive. Completing this information on the patient portal will cut down the amount of new patient paperwork that has to be completed.

Patient Forms

Please print and complete the New Patient Forms and bring them with you to your appointment. Doing so ahead of your appointment will save you time in our office.

Medical Release

Please print and complete the Medical Release Form and bring it with you to your appointment. Doing so ahead of your appointment will save you time in our office.

Privacy Policy

Please download and read our privacy policy before your appointment.

Referrals, Co-payments and Deductibles

If we participate in your insurance plan, we will submit claims for you. All co-pays, cost estimates, deductibles and account balances are due at the time of your visit. If you do not have your co-pay or cost estimate, your appointment will need to be rescheduled. If we do not participate in your insurance plan, payment is expected at the time of service. Any services deemed non-covered and/or applied to your deductible are your responsibility.

No Show or Late Fee

Due to the increased cost of health care, it is very important for us to value our time and commitment to all of our patients. Please give us a 24-hour notice if you change your appointment in order to avoid a no-show fee of $50.00. If you “No-Show” a surgery/procedure, we will apply a $250.00 “No-Show” fee to your account. These fees will have to be paid in full before we schedule you for any additional appointments.

After Hours Policy

If you are having any symptoms suggestive of a life-threatening emergency, please call 911 or go to your nearest emergency room. If you have other non-urgent questions or concerns, please call our office at 770-800-3455 and leave a message. We will return your call the next business day. Non-urgent messages left after 4:00 p.m. on the office voicemail will be returned on the next business day.

Prescription Refills

Refills will be processed within 24 to 72 business hours of receipt of the request. Refill requests received on Fridays will be processed the following business day.

Below are guidelines regarding medication refills:

  • For routine refills please leave a voicemail with your name, date of birth, pharmacy name and the pharmacy telephone/fax number.

  • If you do not follow up regularly in our office, your prescriptions may not be refilled.

  • No new prescription will be provided over the phone or fax.

Spine Conditions


Coccydynia 

 Coccydynia is an inflammation of the tip of the tailbone, called the coccyx. If you’re struggling with this condition, you may be experiencing pain and tenderness between the buttocks that can make it difficult to sit or even walk comfortably.

 

Cervical Neck Pain 

Cervicalgia is a term for neck pain and stiffness, which can occur for a wide variety of reasons including poor sleep posture, underlying nerve conditions, and more. If you’re struggling with chronic neck pain and seeking relief, The Physicians can help provide you with an accurate diagnosis that pinpoints the source of your symptoms.

 

Cervical Radiculopathy 

Cervical radiculopathy is an irritation or compression of one or more nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms and hands, an injury in the cervical spine can cause symptoms in these areas. Cervical radiculopathy may result from a variety of problems with the bones and tissues of the cervical spinal column, and can cause serious back pain that interferes with your daily life. 

 

Lumbar Radiculopathy 

Lumbar radiculopathy, also known as sciatica, is an irritation or compression of one or more nerve roots in the lumbar spine. Because these nerves travel to the hips, buttocks, legs and feet, an injury in the lumbar spine can cause symptoms in these areas. Sciatica may result from a variety of problems with the bones and tissues of the lumbar spinal column. 

 

Degenerative Disc Disease 

Degenerative Disc disease is a term used to describe the pain and symptoms from a degenerated disc in the spine. Degeneration of discs occurs naturally with age -- however, this degeneration does not always result in spinal pain. Degenerative disc disease is most commonly found in the cervical spine (neck) or the lumbar spine (lower back). Because degenerative discs become worse over time, it’s important to receive a diagnosis and treatment as soon as possible.

 

Herniated Disc 

A herniated disc is a common injury in which one of the discs in your spine protrudes from its casing, pressing into one of the nerves in the surrounding area. Herniated discs can affect any part of the spine, and they can cause severe pain and other problems in the arms or legs. 

 

Spinal Stenosis

The spinal column contains open spaces that create passageways for the spinal cord and the spinal nerves. Spinal stenosis is a narrowing of (or an intrusion into) these openings. This can cause a compression of the nerves. Spinal stenosis most commonly affects the cervical and lumbar regions of the spine. 

 

Spinal Spondylosis/ Facet Joint Pain 

Spinal spondylosis is a term used for the natural wear and tear that occurs in the human spine, which can often result in degeneration that causes pain. Spondylosis is common and can become worse as we get older, especially if it occurs in conjunction with other conditions such as osteoarthritis of the spine. 

Facet joint pain describes a deterioration of the facet joints, which help stabilize the spine and limit excessive motion. The facet joints are lined with cartilage and are surrounded by a lubricating capsule that enables the vertebrae to bend and twist. If you’re living with facet joint pain, you may experience serious pain and a reduction in your range of motion.

 

Intercostal Neuralgia 

The intercostal nerves are located in the muscles beneath your ribcage. When these nerves are compromised, you may feel sudden pain in the chest, beneath the ribs, or when performing an action like sneezing or coughing. A common cause of this stems from the herpes zoster infection called Shingles.

 

Sacroiliac Joint Pain

Sacroiliac joint pain, or sacroiliitis, is the term used to describe inflammation of one or both of the sacroiliac joints. The sacroiliac joints are located where the pelvis connects to the lower spine, and are primarily used to absorb shock from the spine. Sacroiliitis most often results in pain in the hips, legs, buttocks and lower back.

 

Post Laminectomy Syndrome 

The term “failed back syndrome” or “post-laminectomy syndrome” is an umbrella term used to describe an unsuccessful operation and does not describe a single syndrome. If you have undergone back surgery and are still experiencing pain, you may be suffering from failed back syndrome (FBS), also known as post-laminectomy syndrome. 

 

Compression Fracture

Compression fractures are tiny cracks in the vertebrae that make up your spine. These usually happen as a result of trauma to your spine; however, they may also present themselves in conjunction with osteoporosis and pathologic fractures. Compression fractures can be extremely painful, and can become worse if left untreated.

 

Stimulators


Spinal Cord Stimulator

A Spinal Cord Stimulator (SCS) is a medical device used to treat chronic pain, especially when other pain management options, such as medications or surgery, have not provided sufficient relief. It works by delivering low-voltage electrical impulses to the spinal cord through a small implanted device, which helps modify pain signals before they reach the brain, providing relief from pain. 

The spinal cord stimulator is particularly effective for neuropathic pain, which is pain caused by nerve damage. It is most commonly used for back pain, leg pain, and pain related to conditions such as failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), ischemic limb pain, and other chronic pain conditions. 

 

Kyphoplasty

Kyphoplasty is a minimally invasive surgical procedure used to treat vertebral compression fractures, which are commonly caused by osteoporosis. The procedure aims to relieve pain, restore vertebral height, and stabilize the spine. Kyphoplasty is typically recommended when the fracture causes significant pain or when conservative treatments like medications or physical therapy are ineffective. It is particularly useful for fractures due to osteoporosis, but it can also be used for fractures caused by tumors or other conditions. 

 

Lumbar Intracept Procedure

The Intracept procedure is a minimally invasive spinal procedure designed to treat chronic low back pain caused by degenerative changes in the spine. Using radiofrequency energy, the procedure selectively targets and ablates (destroys) the basivertebral nerve, which helps reduce pain signals from the vertebra to the brain. It specifically targets pain originating from the vertebrogenic (bone-related) pain in the basivertebral nerve, which is thought to be responsible for pain in the vertebral body of the spine, particularly in the lumbar (lower) spine.  

 

Peripheral Nerve Stimulator

Peripheral nerve stimulation (Sprint System) uses electrical impulses to relieve chronic pain of the effected area. It is believed the electrical pulses can help relieve irritated nerve tissue even after completion of the 60 day treatment period. Evidence demonstrates that even after completion of the treatment period a majority of the patients report continued pain relief.