Pain Management Services
Trigger Point Injections
Transforaminal Epidural Steroid Injections
Radiofrequency Ablation (RFA)
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Frequently Asked Questions
Medical Cannabis Patient Registry Program
Physician Certification Form
Application for Qualifying Patient
Lumbar and cervical radiculopathy
Degenerative joint disease
Arthritis (hip, knee, shoulder, neck, and lower back)
Pain related to cancer treatment
Neck and Low Back Pain
Back pain can range from mild, dull, annoying pain, to persistent, severe, disabling pain in the neck and lower back. Pain in these areas can restrict mobility and interfere with normal functioning and quality of life.
Orthopedic pain is a general term for pain originating from the bone or joints of the body. There are roughly 360 joints within our bodies. It is quite often to have mutliple sources of joint pain. The best treatment model includes medications, physical therapy, precise injections by a Pain Specialist, bracing support, and potentially surgery.
Low back pain can range from dull, intermittent, and simply annoying pain to chronic severe, life-interrupting pain in the lower back. This pain can restrict mobility and interfere with normal physical function, and quality of life.
Neck pain is pain that occurs in the area of the cervical vertebrae. Because of its location and range of motion, the neck is often left unprotected and subject to injury.
Pain in the back or neck area can be acute, which comes on suddenly and intensely, or chronic, which can last for weeks, months, or even years. The pain can be continuous or intermittent.
There are many treatments for neck and low back pain including oral medications, physical therapy, supportive back bracing and ultimately minimally invasive spine procedures (i.e. steroid injections, ablations, nerve blocks).
Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage on the ends of your bones wears down over time. Although osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, knees, hips and spine.
Osteoarthritis symptoms can usually be effectively managed, although the underlying process cannot be reversed. Staying active, maintaining a healthy weight and other treatments may slow progression of the disease and help improve pain and joint function.
The spinal canal consists of bones, discs, joints and nerves. As we age or following an injury the nerves in the spine can be pinched by a herniated disc, swollen joint or displaced bone. Acute trauma Spinal stenosis may lead to leg pain, numbness, and tingling. In advanced cases, weakness may also be present.
Soma– is a Greek word root meaning “body.” Somatic pain, then, is pain that comes from injuries to the outer body—compared to pain derived from the inner organs.
Skin, ligaments, tendons, muscles, joints, and bones can all cause somatic pain.
Bone pain is often described as very intense dull or achy pain (unless it’s a broken bone, in which case, that’s acute, sharp pain).
Joint pain is most commonly from erosion, tears or fluid loss. It is often described as achy, throbbing and even sharp.
Muscle pain is also a somatic pain, and it can develop as part of certain chronic conditions, including fibromyalgia. It often described as tight, cramping and sharp.
Treatments range from oral medications, physical therapy, massage, injections and possibly corrective surgery.
The two most common causes of cancer pain are the cancer itself and the treatments you receive to treat cancer. Most types of cancer pain can be managed with drug and non-drug therapies.
There are several precise nerve blocks that can be completed to remedy pain derived from various cancer origins.
Shoulder pain may arise from the shoulder joint itself or from any of the many surrounding muscles, ligaments or tendons. Shoulder pain that comes from the joint usually worsens with activities or movement of your arm or shoulder.
Often the cause is inflammation which maybe remedied with anti-inflammatory medications, physical therapy and a cortisone injection.
Neuropathy is a disturbance of function or a change in one or several nerves. About 30 percent of neuropathy cases are caused by diabetes.
Patients typically report burning, tingling and numb like discomfort along the hands, ankles and feet.
Treatment options include Vitamin B12 injections to repair damage nerves, oral medications and peripheral nerve blocks performed int he office. With this treatment many reports excellent relief and improved function. All treatments are covered by most insurance companies.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that causes numbness, tingling and burning pain along the hand. Carpal tunnel syndrome is caused when the median nerve is compressed in the carpal tunnel.
It is common with repetitive hand and wrist motions (i.e. computer/desk work). It is a often seen in a work related repetitive injury.
It can be treated successfully with professional supportive wrist braces, physical therapy and nerve injections.
According to the National Headache Foundation, more than 45 million Americans suffer from chronic (long-term), recurring (repeating) headaches; of these, 28 million suffer from migraines. Migraine sufferers lose more than 157 million work and school days every year because of headache pain.
Common symptoms include sharp and throbbing headaches located along the forehead, eyes, temples and back of the head. There is associated nausea, vomiting, and sensitivity to light.
Treatment options include oral medications and Botox injections, which is covered by all insurance companies.
Over 100 million Americans suffer from chronic pain of which knee pain is the second most common cause.
If your knee pain begins to disrupt your ability to walk, exercise, go up and down stairs, work and enjoy pleasurable activities it maybe time to be evaluated at Kalina Pain Institute.
Your medical evaluation will consist of a thorough history and physical examination. A x-ray or MRI of the knee maybe ordered.
Initial treatment may include a cortisone injection to reduce inflammation followed by a course of physical therapy. Supportive bracing may also improve your pain and mobility. This is fully covered by most insurance.
Osteoarthritis associated knee pain can be successfully managed with Hyaluronic Acid injections (Supartz). Supartz is an advanced procedure that replaces lost knee joint fluid. It has been proven to improve pain, function and delay further joint deterioration. This is covered by most insurance plans. Ultimately patient’s often avoid invasive knee surgery.
Managing acute postoperative pain is a major challenge for practitioners, given that more than 80% of patients report pain after surgery, and 75% report the pain as moderate, severe, or even extreme. In more than half of cases, patients report not receiving adequate pain management following their procedure, which raises concerns over the development of chronic pain down the line.
It is crucial to address postoperative pain immediately. This may include medications and interventional pain procedures that may eliminate pain immediately.
Complex Regional Pain Syndrome(CRPS)
Complex regional pain syndrome (CRPS) can affect a patient’s arm, hand, leg, or foot. This generally occurs following an injury.
The symptoms can be mild or severe, lasting for several months or even years.
The root cause of CRPS is not known, but there are treatments available to relieve symptoms and restore limb function.
The symptoms of CRPS include:
- Burning sensation or pain in the arm, hand, leg, or foot
- Pain with light touch
- Loss of motor control
- Tremors or spasms
- Body stiffness
- Changes to skin, hair, and nails on the affected limb
Immediate treatment with medications and nerve blocks is neccesary to prevent spread.
Hyaluronic Acid Injections (Supartz)
Medical management (the use of pain medication)
Spinal Cord Stimulators
Various joint injections
Trigger Point Injections
The cause of your muscle pain or spasms may be one or more trigger points. Your health care provider may decide to inject the painful spots to relax the muscle. This can help relieve your pain. Relaxing the muscle can also make movement easier. You may then be able to exercise and strengthen the muscle and promote healing.
Epidural Steroid Injections
Epidural steroid injections are injections of a short-acting local anesthetic and a long-acting steroid into the epidural space of the spine. These injections are usually used for pain from herniated intervertebral disks (radicular pain), spinal canal stenosis and some mechanical back pain. Epidural steroid injections may help decrease irritation of the nerves within the spinal canal, which can both decrease pain and improve mobility, allowing some patients to participate in physical therapy and other therapeutic programs.
Radiofrequency Ablation (RFA)
Radiofrequency ablation uses an electric current to heat up and destroy an area of nerve tissue thus preventing propagation of the pain signal. It can provide lasting relief for people with chronic pain, especially in the lower back, neck and arthritic joints. This relief lasts a minimum of 6 months.