PriMMed | Treatments
PriMMed is helping patients achieve healthy lifestyles through comprehensive treatment models that provides patients with individualized management plans with spectrum of treatment components.
PriMMed, Southern Nevada Pain Specialists, Dr. Pouya Mohajer, Dr. Franco Lee, Las Vegas, Henderson, Nevada
13671
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Treatments

PRIMMED TREATMENTS

The following details common treatments offered by the PriMMed team. Other treatments options are available, please ask your providers for more information.

Celiac Plexus Block

Multiple factors are the reason of neck pain seen by PriMMed, but the most common neck pain causes are arthritis, car accidents and sports injuries, also some other things can cause trauma to the neck and result in chronic neck pain.

A celiac plexus block is a diagnostic injection that interrupts the pain signals and thus provides pain relief. Located near the upper part of the abdomen along the spine, the celiac plexus is a collection of nerves that can become inflamed or compressed, causing pain and debilitation. A celiac plexus block is an injection that destroys the nerves, thereby interrupting the pain signals and providing relief from pain. A trial block is usually performed, in which local anesthetic is injected into the affected area. If the patient sees short-term pain relief from this trial injection, then the long term neurolytic block is performed, destroying the nerves.

PriMMed acute and chronic lower back pain treatment

Coordinated Physical Therapy

With a multidisciplinary approach to pain management, patients are able to receive the best coordinated care for their treatment. For many patients, physical therapy is an excellent option to not only improve their health but also decrease pain, and prevent further injuries. At PriMMed, we work with physical therapists to safely and effectively coordinate treatment.

Our providers will determine if physical therapy in a good option and work with physical therapists whose programs are covered under the patient’s insurance. Not all physical therapy facilities take all insurances, however. Facilities will only accept our patients if their insurance is accepted. If the insurance procedures are confirmed, a physical therapist will design a therapy regimen based on the patient’s diagnosis. Throughout the patient’s physical therapy treatment, the facility will send over the progress notes to our providers, which are then analyzed. Based on the patient’s development, treatment can be controlled to best fit his or her needs.

Epidural Steroid Injection

The epidural space houses nerves that run the length of the spine and into the low back and legs. If these nerves become inflamed through a damaged disc or contact from the bony structure of the spine, it can cause the patient a great amount of pain.

While an epidural steroid injection will not solve the cause of the pain problem (disc damage, arthritis, spinal stenosis, etc.), it can provide pain relief to help the patient increase function and get back to daily activities. At PriMMED an epidural steroid injection can be performed in our state-of-the-art procedure center. The injection consists of a local anesthetic and a steroid, providing both short and long-term pain relief.

Discography

In between the vertebrae or bones of the spine lay intervertebral discs, which are responsible for cushioning the vertebrae and allowing the spine to move correctly while supporting the body. These intervertebral discs are located all along the spine and are made up of a tough outer shell called the annulus and a soft inner area called the nucleus. The annulus is made up of nerve endings that can sense painful stimuli and require treatment by the team at PriMMed.

The material inside the disc is extremely caustic, and if the disc tears, this material may leak out. It can cause pain and inflammation to the outer part of the annulus as well as the surrounding nerves of the spinal cord. If the disc tear goes untreated, it can become worse and become a disc bulge or disc herniation, causing more pain.

Discography is a diagnostic procedure that can help identify disc tears that may be causing back pain. A thin needle being inserted into the disc and an x-ray contrast dye being injected into the disc. If there are tears, the dye will show up on the screen, and will help determine the best course of treatment for your back pain.

More Treatments PriMMed Offers
Facet or Medial Branch Block

For patients who suffer from back pain that is caused by arthritic changes in the facet joints (joints of the spine), a medial branch block or facet injection may provide pain relief.

The difference between the two injections is merely the placement of the medication. In a facet injection, the medication is injected into the actual facet joint. A medial branch block is where the injection takes place outside the joint space but near the nerves that supply the joint, called the medial branch. Both a facet injection and medial branch block consist of a local anesthetic and possibly a steroid, depending on the treatment plan determined by your pain Specialists at PriMMed.

Radofrequency Ablation (Neurotomy)

Located between adjacent vertebrae, facet joints are positioned to stabilize the spine. Facets joints are found at every level of the spine and provide stability to the neck and lower back. We use our spine and facet joints with practically every motion of our bodies, putting these joints at risk of degeneration. When facet joints become worn down, facet joint syndrome may develop.

One of the best ways to treat facet joint syndrome, a painful condition in which arthritis develops, is with radiofrequency neurotomy. This procedure is utilized to reduce back and neck pain, often resulting from facet joint syndrome, bone spurs, or osteoarthritis. During this minimally invasive procedure, radio waves are sent to the affected nerves through small needles inserted into the skin around the spine.

During the procedure, a SNPS physician will place an intravenous (IV) line into the patent’s arm to deliver medication that will alleviate any discomfort during the procedure. The physicians at PriMMed will use a fluoroscope to position the needles in the accurate areas, targeting affected nerve tissue.

Ganglion of Impar Block

The ganglion impar is a cluster of nerves located just in front of where the sacrum and coccyx come together in the very lower part of the spine. These nerves can become inflamed due to pain syndromes and can result in severe pain.

A ganglion of impar block procedure is an injection of a local anesthetic into this nerve cluster and can be performed by a pain management Specialists at PriMMed. A series of injections is often needed, but most patients will notice a significant reduction in pain symptoms.

Hypogastric Plexus Block

The hypogastric plexus is a collection of nerves that is located in front of the fifth lumbar and first sacral vertebral bodies. This means that the plexus is located near the lower part of your abdomen in the upper front of your pelvis. When these nerves become inflamed, this can cause severe pain in the area of the bladder and lower intestines. Additionally, it can cause pain in the area of the uterus and ovaries in females and in the prostate and testicles in males.

At PriMMed, the pain management doctors can administer an injection of local anesthetic and possibly a steroid to relieve pain symptoms. Many patients will require a series of injections, but will generally see long-term relief from pain.

Hip, shoulder, and other joint injections

Joint injections are used for both diagnostic and therapeutic purposes. For diagnosing a condition, your doctor injects numbing medication into the affected joint and assesses the patient’s pain relief and range of motion. Whether the patient has pain or feels pain relief will affirm or deny the joint as the source of the patient’s pain. If pain relief is achieved, the joint is likely to be the source of the problem.

Joint injections are also used to alleviate patients’ pain. Numbing medication is used as well as time-release cortisone and injected into the joints. This medication combination can reduce inflammation and provide long-term pain relief.

Diagnostic and therapeutic joint injections can essentially be used at any joint of the body. If a patient complains of pain in the hip, shoulder, or any of the spinal joints, joint injection therapy may be beneficial based on an initial evaluation by your PriMMed physician.

Ilioinguinal Nerve Block

The ilioinguinal nerve begins at the low back and travels to the upper ridge of the hip bone and down into the groin, providing sensation for the upper inner thigh and groin area. This nerve can be damaged by trauma, infection, or surgery and can cause severe pain in the groin and inner thigh area. At Southern Nevada Pain Specialists, the pain management Specialistss will generally prescribe neuropathic pain medication as a first line of treatment, but if this fails, then a nerve block may be the next step.

Because ilioinguinal nerve pain is difficult to diagnose and treat, the nerve block may be used as both diagnostic and therapeutic. The pain management Specialists at PriMMed will administer an injection of local anesthetic and steroid into the area around the ilioinguinal nerve. If the patient experiences pain relief, further measures may be discussed, including nerve ablation and peripheral nerve stimulation.

Lumbar Sympathetic Block

A neurological condition that is the result of damage or dysfunction of the central nervous system, a central pain syndrome varies among individuals due to the wide scope of possible causes. Central pain syndromes can be caused by multiple sclerosis, Parkinson’s disease, epilepsy, tumors, stroke, or brain or spinal cord trauma.

The sympathetic nerves can be found along the front of the spinal column and are part of the autonomic nervous system, meaning they control body functions like blood pressure, heart rate, and digestion. After an injury or surgical procedure, these nerves may continue to transmit pain signals, which is a condition known as Complex Regional Pain Syndrome or CRPS. The pain caused by this condition may be severe and burning in nature. CRPS may also cause localized swelling and changes in the appearance of the skin.

The pain management Specialists at PriMMed may recommend a lumbar sympathetic block as a diagnostic or testing procedure. An injection of local anesthetic will be injected near the sympathetic nerves, and if the patient experiences pain relief in the immediate time following the injection, the pain Specialists at our clinic may recommend a series of injections to provide long-term pain management.

Occipital Nerve Block

The occipital nerves are located at the back of the neck at the top of the spine and run up into the back of the head. For patients who suffer from headaches that are caused by the neck (due to injury, trauma, or nerve inflammation) or from occipital neuralgia (headaches and neck pain caused by occipital nerve inflammation), an occipital nerve block may relieve pain symptoms.

The pain management experts at PriMMed may use an occipital nerve block as both a diagnosis and treatment. This procedure, performed in the state-of-the-art procedure center at Southern Nevada Pain Specialists, consists of an injection of local anesthetic into the area surrounding the occipital nerves. If the patient experiences relief from pain, a series of injections may be recommended to provide long-term pain relief. Additionally, if pain is severe, occipital nerve stimulation may be recommended to manage pain more thoroughly.

Piriformis Muscle Injection

In general, piriformis syndrome is treated conservatively and comprehensively at Las Vegas Southern Nevada Pain Specialists. Treatment is intended to restore the normal pathway of the sciatic nerve by rehabilitating the muscle surrounding it while also relieving pain symptoms.

The pain management team at PriMMed may recommend a combination of injections, physical therapy, and exercise to treat pain. Injections will temporarily paralyze the piriformis muscle, thereby relieving the pressure on the sciatic nerve. The patient will also participate in physical therapy to improve flexibility and strength of the pelvic, abdominal, and lower extremities. Generally, six to eight weeks of injections and physical therapy will cause considerable reduction in sciatic pain symptoms.

Sacroiliac Joint Injection

The sacroiliac joint is located in the lower back, and is responsible for connecting the pelvic bone to the lowest part of the spine. There are two sacroiliac joints, each sitting on one side of the sacrum. The sacroiliac joint helps provide stability and flexibility to the lower portions of the spine.

Damage to the sacroiliac joint can cause referred sciatic pain and general lower back pain. At the PriMMed Clinic, the pain management doctors use sacroiliac joint injections both to diagnose and treat pain. An injection consisting of a local anesthetic and a steroid will be injected into the joint. If the patient experiences pain relief, a series of injections may be recommend by the pain doctors to provide long-term results.

Selective Nerve Block

If a patient experiences pain in an arm or leg that seems to follow a single nerve, the pain management doctors at PriMMed may recommend a selective nerve block, placed at the area where the nerve exits the spinal column. Depending on the location and type of pain, a selective nerve block may be performed on any area of the spine; cervical (neck), thoracic (mid-back), and lumbar (lower back).

A nerve block is an injection consisting of local anesthetic and a steroid that will be injected under x-ray guidance at the state-of-the-art procedure center at PriMMed. The block may be diagnostic in nature to assist a surgeon in determining where treatment will be most effective, and a block can be a treatment for pain relief. If the patient experiences pain relief following the nerve block, a series of injections may be recommended for long-term pain relief.

Spinal Cord Stimulation

Using similar technology to a pacemaker, spinal cord stimulation is an advanced treatment for those who suffer from nerve disorders like complex regional pain syndrome (CRPS) and other severe chronic pain conditions that have failed other conservative treatments.

In spinal cord stimulation, electrodes are placed along the spine and interrupt the pain signals that travel to the brain. Severe pain is replaced with paresthesia, a pleasant tingling sensation and requires treatment by the team at PriMMed.

Stellate Ganglion Block

The stellate ganglion is a cluster of nerves located on either side of the voice box in the neck. Inflammation of these nerves may cause pain in the head, neck, chest, or arm that has been caused by reflex sympathetic dystrophy (RSD), post herpetic neuralgia (chronic pain associated with shingles), and pain related to a decrease in blood flow to the heart, known as intractable angina.

A stellate ganglion block may also be used as a diagnostic test to determine whether blood flow can be improved for patients with vascular disease and resulting poor circulation. At PriMMed, the pain management doctors will administer a stellate ganglion block consisting of a local anesthetic and steroid in their state-of-the-art, onsite procedure center.

Suprascapular Nerve Block

Supplying sensory perception to the shoulder joint and surrounding areas, the suprascapular nerve is responsible for supplying sensory fibers to about 70% of the shoulder joint. Chronic shoulder pain caused by arthritis or bursitis of the shoulder joint may be relieved through a suprascapular nerve block.

The pain management doctors at Southern Nevada Pain Specialists may recommend other treatments in combination with a suprascapular nerve block, including physical therapy and exercise.

A suprascapular nerve block injection is made up of a local anesthetic and steroid, and can be administered by a pain management doctor at the onsite procedure center at a PriMMed Clinic. If a patient experiences pain relief following the procedure, a series of injections may be scheduled to provide long-term pain relief.

Trigger Point Injections

When a muscle fails to relax normally, a trigger point forms and creates a tight, ropy area or “knot.” A trigger point can irritate and inflame surrounding nerves, which can then cause referred pain to another part of the body. If not treated, a trigger point can develop scar tissue and cause loss of range of motion and general muscle weakness.

A trigger point injection can be administered by a pain management doctor at PriMMed and consists of a local anesthetic and possibly a steroid. These injections have been shown to be one of the most effective treatments for trigger points, as the injections not only provide nearly instant pain relief, but can also provide long-term relief from trigger point pain.

 

Vertebroplasty/Kyphoplasty

Vertebroplasty and kyphoplasty are both minimally invasive procedures used to treat vertebral compression fractures. With a compression fracture, the vertebrae loses stability, collapses, and produces debilitating pain. During a kyphoplasty procedure, a PriMMed doctor places a thin needle into the spine through a small incision in the skin. A balloon is also used, in which the doctor places the needle through and then inflates the area. The balloon assists in restoring the height of the vertebrae. Then, the doctor injects a cement material between the vertebral spaces to ensure that a collapse does not occur again.

A vertebroplasty is essentially used for the same purpose as a kyphoplasty- minus the balloon. A needle is placed through the skin and into the bone, injecting into the affected area of the spine. Using an x-ray imaging device, the doctor injects a cement material into the spaces between each spine bone to prevent another collapse and further complications.

Patient Education

More than 21% of adult Americans suffer from moderate or severe chronic pain. Pain is the second most common reason that people visit doctors, exceeded only by colds and upper respiratory infections. However, The National Institute of Health claims that 40 million Americans are still unable to find relief from their chronic pain.

Chronic pain is a multifaceted and complex syndrome that adversely affects a person’s physical, emotional, socioeconomic, and spiritual well-being. Oftentimes, chronic pain cannot be effectively treated by medications alone. A comprehensive effort is needed to maximize one’s results. At PriMMed, we successfully treat many types of pain through our comprehensive care plans, which are tailored to each individual patient. Our approach is safe, minimally invasive, and clinically proven to be effective. Learn more about some of the services we perform through our educational videos

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