Blog Archive

Natural Injections for Pain Syndromes Sep 24th, 2019

Presently, muscles, joints, and back pain conditions may be treated with corticosteroids, regenerative injections, or surgery. Corticosteroids are beneficial but have contraindications in patients with diabetes and heart disease. Regenerative therapies such as platelet rich plasma when stem cell injections are expensive, and surgery is highly invasive and risky as...

Minimally Invasive Therapies Jul 15th, 2019

Minimally Invasive TherapyMany treatments are labeled “minimally invasive”. These are usually less aggressive than traditional procedures, and offer a shorter recovery time, and less side effects. Minimally invasive therapies fall between percutaneous procedures and open surgeries. A percutaneous procedures does not involve cutting the skin. Usually a needle will be...

Treatment of Disk Herniations Jun 12th, 2019

Patients seek care for back pain more than almost any other condition. The most common cause of back pain is due to disc abnormalities. These can include degenerative disc disease, disc bulging, and disc herniations. An intervertebral disc is comprised of an inner nucleus, the soft shell gel which fills...

Treatment of Tendinitis Jun 12th, 2019

Tendons are tissues which connect muscles to bones.  They aid in joint mobility and stability. Tendinitis, or Tendinopathy, is inflammation of various tendons, are common and can occur throughout the body. This condition can lead to chronic pain with loss of functioning and disability.   The most common areas where...

Myths and Facts About Epidural Steroid Injections for Chronic Back Pain Mar 18th, 2019

Highly skilled pain management specialists have used epidural steroid injections for decades to help reduce the inflammation that can trigger significant nerve irritation and pain in the back, neck, arms, and legs. Despite the success of this pain management tool, however, many myths exist about what the injections can do...

Why You Should Seek an Immediate Medical Evaluation After an Automobile Accident Feb 28th, 2019

Did you know that there are more than 6 million automobile accidents each year in the United States? And of these accidents, more than 3 million people get injured. And of these 3 million injuries, two-thirds of them cause long-lasting problems. Because of these statistics, Todd S. Koppel, MD, and...

Arthritis of the Spine Dec 29th, 2018

A common thing I hear from patients who have chronic back pain is that a have been told they have arthritis in their spine. For several reasons, hearing this never sits right with me. First, descriptions such as degeneration and arthritis suggests an incurable condition. Arthritis is a more fitting...

Treatment of Chronic Neck Pain Nov 22nd, 2018

What Causes Chronic Neck Pain? A majority of chronic neck pain is due to injury to the cervical facets.  This condition is known as cervical facet arthropathy or cervical facet syndrome. Diskogenic disease is another, albeit unlikely cause of localized neck pain. What are the Cervical Facet Joints? Facet joints...

Treating Vertebrogenic Neck & Low Back Pain Oct 20th, 2018

This is a bit of an oversimplification, but the crust of diagnosing a patient’s neck or back pain comes down to three causes.  Neck or back pain may be caused by three basic conditions, it may be discogenic (due to the intravertebral disc’s), spinal (such as from spinal stenosis),, or...

Chronic Muscle Pain Syndrome Oct 10th, 2018

Myofascial pain is pain which originates from skeletal muscular in the body.  Skeletal muscle is the most abundant tissue in the human body.  More than 600 muscles work to aid the body in movement and stability.  When muscle tissue is healthy, movement can be performed through a wide range of...

Disk Herniation Treatment with Percutaneous Disk Decompression (video) Oct 9th, 2018

Percutaneous disk decompression is a minimally invasive, outpatient procedure for contained herniated disks. This can replace traditional open disk surgery. It is used to treat neck pain, low back pain, disk herniations, pinched nerves, arm pain and leg pain. I have been performing these therapies for 10 years without any...

Treatment of Sciatica Aug 25th, 2018

Many patients come to my office telling me that they have sciatica or a pinched nerve in their neck or back. The first thing I would like to clear up is that sciatica is a symptom and not a diagnosis. Most people correctly think of sciatica as pain which is...

Lumbar Facet Injection for Chronic Lower Back Pain Aug 7th, 2018

What Are Lumbar Facet Joints? Facet joints connect the vertebrae (the bones of the spine) and help guide the spine during movement. The lumbar region of the spine contains five vertebrae and is located in the lower back. Facet joints are found on both sides of the spine. Each is...

Treatment Protocols for Common Back Conditions Jul 30th, 2018

I have been practicing interventional pain management for over 20 years, and over that time have treated thousands of patients.  Many of these patients have had previous injections that failed.  I have over the years developed what I feel are tried and true diagnostic protocols and therapeutic techniques. I recently...

Sacroiliac Joint Injection for Chronic Low Back and Buttock Pain Jul 29th, 2018

What Are Sacroiliac Joints? Sacroiliac joints connect your spine to your hip bone. They connect the bottom of the spine, called the sacrum, to the outer part of the hip bone, called the ilium. You have two sacroiliac joints. One is found on each side of the sacrum. Sacroiliac joints...

Thoracic Epidural Steroid Injection for Upper & Mid Back Pain Jul 29th, 2018

What Is The Epidural Space? The dura is a protective covering of the spinal cord and its nerves. The space surrounding the dura is called the epidural space. In the upper back, it is called the thoracic epidural space. What Causes Pain In Epidural Space? The thoracic area of the...

Radiofrequency Ablation (RFA) For Chronic Neck, Upper and Lower Back Pain Jun 16th, 2018

What Are Facet Joints? Facet joints connect the vertebrae, the bones of the spine, in neck, upper back and lower back. They help guide your spine when you move. Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Facet joints are...

Lumbar Radiofrequency Ablation (RFA) for Chronic Lower Back Pain Jun 6th, 2018

What Are Lumbar Facet Joints? Facet joints connect thevertebrae (the bones of the spine) and help guide the spine during movement.The lumbar region ofthe spine contains five vertebrae and is locatedin the lower back. Facet joints are found on both sides of the spine. Each is about the size of...

Cervical Epidural Steroid Injection for Neck and Arm Pain Jun 4th, 2018

The dura is a protective covering of the spinal cord and its nerves. The area surrounding the dura is the epidural space. In the neck, this space is called the cervical epidural space. What Causes Pain In The Epidural Space? The cervical area of the spine has seven bones, called...

Lumbar Epidural Steroid Injection for Lower Back and Leg Pain Jun 4th, 2018

The dura is a protective covering of the spinal cord and its nerves. The area surrounding the dura is the epidural spaces In the lower back, this space is called the lumbar epidural space. What Causes Pain In The Epidural Space? The lumbar area ofthe spine has five bones, called...

More Than Just Managing: Does your pain need an intervention? May 29th, 2018

Dr. Todd Koppel, Division Chief of Pain Management at Trinitas Regional Medical Center. Aside from cold, flu and upper respiratory conditions, the most common reason people seea doctor is due to neck and lower back pain. The causes of neck and back pain can vary greatly. Some are attributable to...

Why You Should Avoid Back Surgery May 27th, 2018

Every year thousands of people undergo surgery on their neck and lower back.  Many of these could and should have been avoided. Surgery on his spine is very aggressive, has a long recuperative time, various complications, and most importantly in many instances does not result in long-term improvement of the...

Alternatives to Steroid Injections May 20th, 2018

Corticosteroid injections are the most common types of injections for a variety of painful conditions.  Sports medicine and pain management physicians utilize corticosteroid injections in the treatment of all sorts of joint and spinal conditions.  Such intra-articular degenerative conditions include bursitis, tendinitis and arthritis.  Many different types of spinal conditions...

30 Reasons Why Visiting Your Doctor More Often is So Important Jul 7th, 2017

Please click on the following link: 30 Reasons Why Visiting Your Doctor More Often is So Important

Why Go to a Board Certification Physician Oct 29th, 2012

I have been in the field of pain management since 1997.  Since that time I have seen it explode from a relatively unknown specialty into an extremely popular field.  There are several reasons for this.  The most important is that there was a need for physicians with such specialty training.  Pain management physicians...

PLATELET RICH PLASMA THERAPY May 6th, 2012

PRP therapy offers a promising solution to accelerate healing naturally without subjecting the patient to significant risk.  PRP is a treatment is a hew health sector known as “Orthobiologics”.  The philosophy is to merge cutting edge technology with the body’s natural ability to heal itself. PRP has been used in...

Provocative Discography Nov 14th, 2011

A discography, or discogram, is a diagnostic procedure used to assist in the diagnostic/therapeutic workup of a patient who is having refractory back pain. The “tools” of a pain specialist are the interventions which can be done to diagnose the “pain generator”. This is the structure which is causing the...

Spinal Cord Stimulation for Chronic Pain Oct 12th, 2011

SPINAL CORD STIMULATION Spinal cord stimulation is the blockage of pain signals at the level of the spinal cord.  This is accomplished by the stimulation of nerves within the spinal cord.   It works by blocking the transmission of pain impulses to the brain.  Many patients have tried transcutaneous electrical nerve...

Medical Management for Chronic Pain Aug 27th, 2011

Most if not all pain management physician’s websites talk about interventions for treating back pain.  Few if any discuss medication management.  This is a complicated topic, but one which needs to be addressed.  All physicians in this field should prescribe medications for chronic pain, but not all do.  First of...

Ablation Techniques for Pain Relief Aug 14th, 2011

Treatments for herniated intervertebral disks are most common, but many other treatments exist for acute and chronic neck and low back pain.  In my last posting I discussed the anatomy of the spine.  The point was that there are a lot more pain sensitive structures than just the inverterbral disks. ...

Causes of Back Pain Jul 12th, 2011

In order to discuss what treatments are performed, you need to understand some of the basic anatomy of the spine.  This article will concentrate on the lumbar spine.  The spine is covered and supported by many ligaments and muscle groups.  Beneath these muscles are the bones that form the spinal...

Percutaneous Diskectomy May 2nd, 2011

My entire career has been devoted to treating patients with the least number and simplest modalities of the spine.  Performing minimally invasive interventional treatment for disc herniations means less postoperative discomfort, a shorter recuperative time, and less risk of complications (most importantly resulting in an unexpected and unintended exacerbation of...

MILD: Minimally Invasive Lumbar Decompression May 2nd, 2011

Spinal Stenosis, the closing of the spinal column, is an extremely common condition which develops as we get older. It is by definition narrowing of the spinal canal. The spinal structures, which include the vertebral bodies, intervertebral disks, and facet joints degenerate as they get older.  As this occurs they...

When should you see an interventional pain physician? Apr 11th, 2011

Cervical and lumbar spine injuries are the second most common reasons why patients will see a physician.  Common diagnoses include disc herniation’s, pinched nerves, arthritis, sciatica, and degenerative disc disease. These can arise from repetitive injury, incorrect posture, stress is on the spine such as with heavy bending and lifting,...