We Help You Live With Less Pain
Your chronic or sudden acute pain can change your whole life. It impacts your ability to do even the smallest things that you once took for granted. It keeps you up at night. Even walking or merely sitting down can be extremely painful. Unfortunately, we encounter this ever day with patients that come to see our physicians for medical treatment and pain relief. At Paragon Health our job is to listen to your challenge, to understand your pain, its impact on your life and how we can work with you to treat your painful medical condition through various means from small measures, to if needed minimally invasive procedures, or perhaps a surgical intervention, if needed as a last resort to alleviate your pain. Your chronic or sudden acute pain is typically the most common in your neck or back. It can be caused by an injury, a fall, lifting a heavy object or just merely the fact that you are getting older. Our treatment protocol is to listen to your story, evaluate your painful situation through diagnostic tests such as MRI or CT imaging. We then work with you to create a customized medical treatment plan which may include injections to alleviate the pain, perhaps physical therapy, or if needed a more comprehensive intervention. Our goal at Paragon Health is to work with you to determine what is causing your pain and to provide sound medical care and treatment to bring about recovery in order for you to lead a pain free life. We don’t want you to just accept your pain as part of life, we want to help you eliminate the pain.
Listed below are some of the conditions we treat. We can discuss these medical interventions with you, and the information below is a guide to help you better understand the medical treatment intervention that is recommended by our physicians, based upon your painful medical challenge.
Primary Medical Treatments
The list below identifies the primary medical treatments that Paragon Health pain management physician specialists and neurosurgeons offer at our clinic locations. Many of these services can be performed within the office clinic setting, while others may need to be performed within one of our surgery centers, or perhaps within a hospital setting in Orange County, CA (Newport Beach area) or Bakersfield (Kern County, CA). Our clinic locations are located in Bakersfield, Newport Beach, Lakewood, Monterey Park and Encinitas (San Diego County). The listing below offers both a full spectrum of services, a full description of the services Paragon Health clinicians provide, and also where the service line will be performed, (surgery center/office setting, or hospital).
Injections
Sacroiliac Joint Injection
The sacroiliac joint may be thought of as a very large facet joint. It is the place where the low back meets the “hip bone.” The physician places an injection of a strong anti-inflammatory medicine into this joint can help reduce pain caused by inflammation or injury. This medical service can be performed in a surgery center location.
Cervical Interlaminar Epidural Steroid Injections
A cervical epidural steroid injection is a procedure performed by our physicians, that involves placing a small amount of strong anti-inflammatory medicine into a fluid space surrounding the spinal nerves to help reduce pain in the neck and arms often caused by a “pinching” or irritation of these nerves. This medical service can be performed in a surgery center location.
Cervical Transforaminal Epidural Steroid Injections
Cervical transforaminal epidural steroid injections are often for the same reasons as above, except the injections are specially targeted by the physician toward a specific pinched nerve or nerves. This medical service can be performed in a surgery center location.
Lumbar Epidural Steroid Injections
Similar to the cervical epidural injections described above, a lumbar epidural steroid injection a steroid medicine around the spinal nerves of the low back is placed by our physician. These nerves can often get “pinched” by a bulging disc or other spine problems, and may cause lower back pain and/or leg pain, which is referred to as sciatica. This medical service can be performed in a surgery center location.
Facet Joint Injections
Facet joints are small joints at the back of the spine that can often become painful due to injury, inflammation, or strain. A facet joint injection, performed by a physician, places a strong anti-inflammatory medication by the physician into the joint itself, which can numb the joints and help reduce the pain. These can be performed in the cervical, thoracic, or lumbar spine by our physician. (Neck, middle of your back, or in the back waistline area). This medical service can be performed in a surgery center location.
Pain Management
Lumbar and Sacral Radiofrequency Rhizotomy
A lumbar (lower back) radiofrequency neurotomy (or radiofrequency rhizotomy) is a minimally invasive procedure, performed by our physician, that can help significantly decrease or possibly even eliminate the pain that can occur from a injured facet or sacroiliac joints. This is accomplished by “treating” the medial branch nerves (the same nerves targeted in a “medial branch block”) that carry pain signals to these joints. We use using specially-designed needles to accomplish this procedure and ease or eliminate the pain.. It is a relatively simple outpatient procedure that usually takes less than an hour for our trained physician to complete. This medical service can be performed in a surgery center location.
Cervical Facet Radiofrequency Rhizotomy
A cervical (neck area) radiofrequency neurotomy (or radiofrequency rhizotomy) is a minimally invasive procedure, performed by a physician, that can help significantly decrease or possibly even eliminate the pain that can occur from injured facet or sacroiliac joints. This is accomplished by “treating” he medial branch nerves (the same nerves targeted in a “medial branch block”) that carry pain signals to these joints, using specially-designed needles. It is a relatively simple outpatient procedure that usually takes less than an hour to complete. This medical service can be performed in a surgery center location.
Epidural Injections
Epidural injections are given by our treating physician to relieve pain in the neck, back, arm and leg(s) due to inflammation of spinal nerves from conditions such as spinal stenosis, spondylolysis, herniated disc, degenerative disc and sciatica. Epidural injections contain a strong anti-inflammatory agent called corticosteroid and an anesthetic for pain relief. During the procedure, a thin hollow needle is inserted into the epidural space. Our physician is guided by fluoroscopic X-ray to place the needle in the correct position. This system gives real time X- ray images of the positioning of the needle in the spine on a monitor for the treating physician to view. Some of the complications include spinal headache, infections, allergic reactions and worsening pain. To help minimize risk you will need to follow all of the instructions provided to you by your treating physician. The physician will review all of these instructions prior to the procedure and after it as well. This medical service can be performed in a surgery center location.
Medial Branch Radiofrequency Ablation
The medial branches carry pain sensation from the facet joints to the spine and brain. This procedure provided, by the physician, will treat the pain attributed to the facet joints. Facet joints are joints between adjacent vertebral bones that provide stability to the spinal column. Wear and tear or mechanical stress may damage the facet joints, resulting in pain and inflammation. This medical service can be performed in a surgery center location.
Radiofrequency Ablation (RFA)
RFA also called rhizotomy or neurotomy is a novel non-surgical technique which uses the heat produced by radiofrequency waves to treat the nerves transmitting pain signals to the brain. Performed by a physician, this procedure may be performed to treat painful facet joints in the spine that usually cause chronic low back and neck pain. Radiofrequency ablation treatment is considered only after it is confirmed that the cause of back pain lies in the facet joints, through performing a diagnostic facet joint injection. The procedure is minimally invasive and administration of general anesthesia is not required. You will be conscious throughout the procedure and lying on your stomach. Only a small area over your back or neck which requires treatment is cleansed and numbed.
During the procedure, our physician will direct special radiofrequency needle electrodes close to the affected facet joints in such a manner that the needle tip lies near the medial branch nerves. This is performed under the guidance of a fluoroscope, a special kind of X-ray machine that displays live images on a monitor. Radiofrequency energy is then used to heat the needle tip so that the nerve gets treated, subsequently reducing the pain. The entire procedure may last about an hour or two. You will usually be able to return home an hour after the procedure, but may experience some soreness at the needle sites for a few days. The use of a cold pack can help relieve the discomfort. Complications are rare but can include possible nerve damage, some bleeding, and possible infection. Radiofrequency ablation can provide effective relief for a period of 6-12 months. This medical service can be performed in a surgery center location.
Spinal Cord Stimulation
Spinal cord stimulation (SCS) is a procedure, provided by a physician, that uses an electrical current to treat chronic pain. A small device called a pulse generator is implanted in the back and sends electrical pulse signals to the spinal cord. These pulses act to disrupt the nerve signals that make you feel pain in your affected regions of the spine and limbs. It “replaces” the pain sensation with what most patients describe as a mild tingling sensation. While the treatment does not work for everyone, most patients who qualify for this stimulation therapy report a significant reduction in overall pain, as well as an increased ability to participate in normal family and work activities. Many patients find that they can decrease or stop taking painkillers or other pain medications after undergoing spinal cord stimulation. Our physician usually will first insert a temporary stimulator through the skin (percutaneously) to give the treatment a trial run for a period of about 5 to 7 days. If the trial is successful, your doctor can implant a more permanent stimulator. After this same-day outpatient procedure is complete, you and our physician will determine the best pulse strength and usage schedule for long-term use. This medical service can be performed in a surgery center or a hospital location.
Spine Surgery
PLIF
A posterior lumbar interbody fusion (PLIF) is a type of spinal surgery, performed by a physician, that involves removing damaged disc material and inserting a bone graft between two vertebrae. “Posterior” refers to the method of approaching the spine from the back of the body, and “lumbar” refers to the lower region of the spine. PLIF is particularly useful in the correction of degenerative lumbar deformity such as spondylolisthesis, scoliosis or disc space collapse and in the management of associated of neurological compression. This medical service can be performed in a surgery center or a hospital location.
TLIF
A transforaminal lumbar interbody fusion (TLIF) is a type of spine surgery, performed by a physician, that involves approaching the spine from the back, or posterior, of the body to place bone graft between two vertebrae. The procedure is performed using minimally invasive surgical techniques. This medical service can be performed in a surgery center or a hospital location.
Anterior Cervical Decompression and Fusion
This procedure includes fusions with metallic and other implants, bone grafting procedures, and spinal instrumentation, as well as microsurgical decompression. The procedure, performed by a physician, is to remove pressure from the spinal cord and/or nerve roots through the removal of intervertebral discs. Bone or strut grafts, with or without the addition of supporting titanium plates and screws, are then inserted by the physician to replace removed discs, and fuse the vertebra to achieve stability. This medical service can be performed in a surgery center or a hospital location.
Anterior Lumbar Spinal Fusion
This procedure includes a mini-open approach, laparoscopic and thoracoscopic techniques, endoscopic fusions, and endoscopic micro disc surgery. This procedure, is performed by a physician, to reduce back or leg pain caused by natural degeneration of disc space. Through an incision in the abdomen, a portion of the affected disc space is removed and replaced with an implant that may or may not be supported by screws and rods inserted at the back of the spine. This medical service is performed in a hospital location.
Kyphoplasty
This is a minimally invasive procedure, performed by a physician, and guided by fluoroscopy designed to stop pain caused by spinal fracture. A small balloon is inserted into the vertebrae through a tube that elevates the fracture and returns it to a more normal position. This medical service can be performed in a surgery center location.
Micro-Lumbar Discectomy or Laminectomy
This intervention is a minimally invasive surgical decompression procedure is performed by a physician, and used to remove the portion of the intervertebral disc that is compressing the spinal nerve root in patients with lumbar herniated discs. This medical service can be performed in a surgery center location.
Posterior Cervical Microsurgical Decompression/Foraminotomy
This intervention is a minimally invasive procedure, performed by the physician, and is designed to reduce neck pain through the decompression of single or multiple cervical (neck) nerve roots. This medical service can be performed in a surgery center or a hospital location.
Posterior Cervical Microsurgical Decompression and Fusion
This intervention is a minimally invasive procedure used by the physician, to treat abnormal movement, pain, and/or narrowing of the cervical (neck) spine area. Microsurgery is performed to decompress the spinal cord and/or nerves, and small titanium screws are inserted to help stabilize abnormal movement or neck instability. This medical service can be performed in a surgery center or a hospital location.
Posterior Lumbar Spinal Fusion
This medical intervention includes minimally-invasive techniques whereby a medical procedure, by the physician, is used to combine and immobilize two or more vertebrae in order to eliminate pain caused by abnormal motion of the vertebrae. This medical service can be performed in a surgery center or a hospital location.
Cervical Artificial Disc Replacement
This intervention is a procedure, performed by a physician, to reduce pain caused from a herniated or ruptured disc, or from degenerative disc disease. An artificial disc in inserted into the disc space, preserving natural motion of the cervical spine by functioning as a joint. This medical service can be performed in a surgery center or a hospital location.
Lumbar Artificial Disc Replacement
This intervention is a procedure, performed by a physician, to reduce pain caused from a herniated or ruptured disc, or from degenerative disc disease. An artificial disc in inserted into the disc space, preserving natural motion of the lumbar spine by functioning as a joint. This medical service is performed in a hospital location.
Non-Surgical Interventions/Tests
Medial Branch Blocks
Medial branch nerves are tiny nerves that send nerve signals to and from the facet joints in the spine. When the joints are damaged (for example form injury, inflammation, or strain), these nerve signals are often painful.
A medial branch nerve block that is performed by a physician, temporarily blocks that pain signal and thus can serve as a useful procedure to help with diagnosis and treatment of the facet pain. These injections can be performed in the cervical (neck), thoracic (mid-back), or lumbar spine (lower back). This medical service can be performed in a surgery center location.
Lumbar Sympathetic Block
A lumbar sympathetic block typically involves either one or a series of injections, given by a physician, of anesthetic agent to a group of nerves known as the lumbar sympathetic chain. These injections may help relieve leg pain (sciatica) caused by certain pain conditions, including complex regional pain syndrome, which can occur after an injury to a joint or limb. This medical service can be performed in a surgery center location.
