PUTTING OUR PATIENTS FIRST

Our chronic pain management team understands the impact of living with debilitating pain and we are committed to providing you with the most successful medical care to accomplish optimal pain control so that you can enjoy living your life to the fullest. At our clinic, we specialize in minimally invasive pain management. We provide the highest quality of specialized medical services and compassionate care in a friendly, team-oriented environment.

We will work with you to customize a treatment plan that is unique to your specific needs. Our goal is to increase each patient's quality of life. Please call us today at (321) 264-2011 to schedule an appointment with one of our caring and professional staff.

Our Neurology, Headache, & Pain Clinic provides pain management services to Titusville, Cocoa and the Space Coast.

 

OUR SERVICES

Here is a list of common conditions that we offer treatment options for:

  • Epilepsy and Seizures
  • Memory loss and Alzheimer’s disease
  • Strokes and post stroke follow-up
  • Parkinson’s disease
  • Multiple Sclerosis
  • Tremors
  • Headaches and Migraines
  • Nerve Pain and Neuropathies
  • Fibromyalgia
  • Muscle weakness
  • Trigeminal Neuralgia
  • Shingles
  • Chronic Pain
  • Addiction Medicine
  • Automobile Injury evaluation and treatment

 

 

 

 

 

A partial list of services that we offer

Click to learn more about each service

Trigger Point Injections

Trigger point injection (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.
I insert a small needle into the patient's trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) or alternative medications can be used.
TPI can be used to treat focal muscle pain, fibromyalgia and tension headaches, myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments.

Lumbar Epidurals

An epidural steroid injection delivers steroids directly into the epidural space in the spine.
The epidural space encircles the dural sac and is filled with fat and small blood vessels. The Dural sac surrounds the spinal cord, nerve roots, and cerebrospinal fluid (the fluid that the nerve roots are bathed in).
Typically, a solution containing cortisone (steroid)), and saline is used.  A steroid is usually injected as an anti-inflammatory agent. Inflammation is a common component of many low back conditions and reducing inflammation helps reduce pain. I use Celestone in my office.

Spinal Tap

A spinal tap is a procedure performed when a doctor or health care professional needs to evaluate the cerebrospinal fluid (also known as spinal fluid or CSF). Spinal tap is also referred to as a lumbar puncture, or LP.
Some of the reasons we do spinal taps are the following. 
To look for infection, headaches, to evaluate for uncommon diagnoses such as multiple sclerosis, Lyme disease, Guillain-Barre syndrome, CIDP.  It can also be used as a treatment modality in cases of raised pressure causing headaches.
A spinal tap can be performed in the office.  You will wear a hospital gown during the test.  You will either: Lie on your side with your knees drawn as close to your chest as possible and your chin toward your chest; or lie on your stomach with a small pillow beneath your lower abdomen.  After cleaning your back with an antiseptic, sterile cloths will be placed around the area.  A local anesthetic (pain-relieving medication) will be injected into the area of your back that the fluid will be drawn from. You may feel a slight burning sensation.  When the area is numb, a hollow needle is inserted in the lower back between the two lumbar vertebrae. This sometimes causes pressure.  The spinal canal is penetrated, and fluid is collected (the spinal cord is not touched by the needle during the test).  The needle is removed after the fluid is removed. The area will be cleaned with an antiseptic and covered with a small bandage.  A blood sample may be needed and you may have to go to the lab after the procedure.
Instructions for patients undergoing the procedure.
Take all your regular medications.
No food or drinks 4 hours prior to the procedure.
Stop aspirin or Plavix 5 days before the procedure.
Bring along a driver.
After the spinal tap lay down for at least 24 hours.  Drink plenty of fluids and caffeinated drinks.  If you have a headache that occurs upon standing strict bed rest of up to three days is recommended, if the headache persists longer than three days this may be the symptom of a CSF leak and an injection called a blood patch may be needed.  Call our office if you have any new symptoms.

Botox

Botox is a brand name of a toxin produced by the bacterium Clostridium botulinum. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.
Botox is approved by the FDA for blepharospasm (uncontrolled blinking) and strabismus (lazy eye) Dystonia (severe muscle spasms) Facial wrinkles, Chronic Migraines and other neurological conditions.
Botox blocks signals from the nerves to the muscles. The injected muscle can no longer contract.  Getting Botox takes only a few minutes and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect and it is best to avoid alcohol at least one week prior to treatment. Aspirin and anti-inflammatory medications should be stopped two weeks before treatment as well in order to reduce bruising.
The effects from Botox will last four to six months.
Temporary bruising is the most common side effect of Botox. Headaches, which resolve in 24-48 hours, can occur, but this is rare. A small percentage of patients may develop eyelid drooping or neck drooping. This usually resolves in three weeks. This usually happens when the Botox moves around so you shouldn't rub the treated area for 12 hours after injection or lay down for three to four hours. Insurance coverage varies for Botox injections, depending largely on the medical necessity of your condition. Botox is not generally covered by insurance when used for cosmetic purposes. Check with your insurance carrier for coverage details.

Nerve Blocks

Nerve blocks are used for pain treatment and management. There are several different types of nerve blocks that serve different purposes.
Therapeutic nerve blocks are used to treat painful conditions. Such nerve blocks contain local anesthetic that can be used to control acute pain.
Diagnostic nerve blocks are used to determine sources of pain. These blocks typically contain an anesthetic with a known duration of relief.
Preemptive nerve blocks are meant to prevent various areas of pain require different nerve block types. Below are a few of the available nerve blocks, followed in parentheses by some of the parts of the body for which they are used.
Common Nerve Blocks performed in our office include Occipital, Supraorbital nerve blocks.
A small amount of local anesthetic and long acting steroid usually kenalog is injected around the nerve and this causes numbness in that area.  Nerve blocks last for a few hours but the pain relief could last for months.

EEG (Electroencephalography)

The electroencephalogram (EEG) is a measure of brain waves. It is a readily available test that provides evidence of how the brain functions over time. . Electrodes are attached to the scalp. Wires attach these electrodes to a machine, which records the electrical impulses. The results are either printed out or displayed on a computer screen. Different patterns of electrical impulses can denote various forms of epilepsy.
Most commonly it is used to show the type and location of the activity in the brain during a seizure. It also is used to evaluate people who are having problems associated with brain function. These problems might include confusion, coma, and brain tumors, long-term difficulties with thinking or memory, or weakening of specific parts of the body (such as weakness associated with a stroke.

Nerve Conduction Study (NCV)

A nerve conduction study (NCS) is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body.  Nerve conduction velocity (NCV) is a common measurement made during this test. The term NCV often is used to mean the actual test, but this may be misleading, since velocity is only one measurement in the test suite.
Nerve conduction studies are used mainly for evaluation of paresthesias (numbness, tingling, burning) and/or weakness of the arms and legs. The type of study required is dependent in part by the symptoms presented. A physical exam and thorough history also help to direct the investigation.
Some of the common disorders that can be diagnosed by nerve conduction studies are:  Peripheral neuropathy, Carpal tunnel syndrome, ulnar neuropathy, Guillain-Barre syndrome, Facioscapulohumeral muscular dystrophy, Spinal disc herniation, Cubital Tunnel Syndrome, Tarsal Tunnel Syndrome, Peroneal neuropathy

Motor NCS are performed by electrical stimulation of a peripheral nerve and recording from a muscle supplied by this nerve.  Sensory NCS are performed by electrical stimulation of a peripheral nerve and recording from a purely-sensory portion of the nerve, such as on a finger. The procedure is minimally discomforting but has no side effects.

EMG (Electromyography)

EMG is the study of muscles using a special needle.  EMG gives additional information about the muscles and nerves and is done in conjunction with Nerve conduction studies.
We perform this test as part of our neurology workup but also if your doctor refers you to us for testing.

Suboxone therapy

We are a registered prescriber for Suboxone therapy for opiate addiction.
Opioid dependence is a challenging and complicated condition, but it can be treated. If you’re working to overcome opioid dependence, you know the experience can sometimes be overwhelming. That’s why the formulation of your medication should help make your experience convenient.
SUBOXONE Film is a narcotic medication indicated for the maintenance treatment of opioid dependence, available only by prescription, and must be taken under a doctor's care as prescribed. It is illegal to sell or give away your SUBOXONE Film.
We follow all DEA guidelines in prescribing Suboxone.  Treatment is customized and so no general guidelines will suffice.  Additional information can be obtained at Suboxone.com.