When conservative first-line therapies such as rest and ice fail to provide relief, interventional pain management techniques may be an appropriate next step. Injections of corticosteroids and anti-inflammatory medications directly into affected joints can provide effective pain control, making physical therapy and daily living tasks easier and more comfortable. Traditionally, physicians used palpation to “feel” where to place a needle. At Skyline Physical Medicine & Rehabilitation, we employ the most advanced technique, which involves the use of ultrasound (identical to what is used to monitor pregnancies) to guide the needle and deliver the injection precisely into the source of pain. Ultrasound guidance allows us to see the needle, bones, muscles, tendons and even nerves and deliver the medication with millimeter-level accuracy. The result is more effective, longer-lasting pain relief. For the best and most advanced sports medicine in Lower Manhattan, please Request a Consultation today.
A careful, thorough history and physical examination are often sufficient for an accurate and proper diagnosis. But in some cases, the subtlety of a condition warrants the use of more specialized techniques to arrive at a conclusive diagnosis. At Skyline Physical Medicine & Rehabilitation, we are fellowship-trained in electrodiagnostic testing, which we use to assess the ability of the nervous system to conduct electrical impulses and to evaluate muscle and nerve function. Electromyography and Nerve Conduction Velocity Studies provide hard data associated with either the absence – or presence and location – of nerve damage. Combining data with the history, physical examination and years of training and experience in Physical Medicine and Rehabilitation leads us to an accurate diagnosis and customized treatment plan and leads you to improved clinical outcomes and a faster return to your favorite activities. Left unchecked, nerve damage can result in permanent limitations or loss of function, so please Request a Consultation today if you are experiencing muscle or nerve pain.
Much has been written about Platelet Rich Plasma (PRP) Injections, and a few high-profile athletes have credited it with speeding their recovery and return to competition. It is very much a cutting-edge pain management technique – one we are proud to offer at Skyline Physical Medicine & Rehabilitation – but one that is not always covered by insurance. Whether you are an elite athlete, weekend warrior, or suffer from arthritis, PRP is a treatment option you should consider if you suffer from chronic joint pain, tendon or ligament injuries. PRP is a non-surgical procedure we provide right here in our office in Lower Manhattan. We generally pair it with a regimen of physical therapy to improve flexibility and strength in the affected area. If you are interested in having PRP injections or would like to discuss them as a pain treatment option, please Request a Consultation today.
A Transforaminal Epidural Steroid Injection combines a short-acting anesthetic with a long-acting steroid. The solution is injected into the foramen, the opening at the side of the spine where the nerve root exits the spinal column. The short-acting anesthetic provides instant pain relief, confirming that the affected nerve is being targeted, while the steroid provides long-term reduction in inflammation leading to effective pain relief. Transforaminal Epidural Steroid Injections are conducted under x-ray guidance for pinpoint accuracy. Following a thorough evaluation and diagnosis, we may recommend a Transforaminal Epidural Steroid Injection for certain neck and lower back conditions. They are often most effective in patients with a recent onset of pain – we don’t recommend “playing through pain.” Please Request a Consultation to learn more about this pain treatment option today.
Interlaminar Epidural Steroid Injections are often used when a bulging disc, bone spur or narrowing of the spinal canal “pinches” a nerve in the epidural space – the area surrounding the sac that holds the spinal cord, spinal fluid and nerves. The pinching results in inflammation, which causes pain, numbness and tingling. The injection combines a short-acting anesthetic with a long-acting steroid. The short-acting anesthetic provides instant pain relief, confirming that the affected nerve is being targeted, while the steroid provides long-term reduction in inflammation leading to effective pain relief. Most adults will experience neck or back pain at some point in their lives, but if you have persistent, recurring or debilitating pain, please Request a Consultation and come see us at our Lower Manhattan location.
Medial Branch Blocks disrupt pain signals sent from medial branch nerves to facet joints – the small joints located between each vertebra that provide stability and flexibility to the spine. Though they can be used to provide pain relief, Medial Branch Blocks do not treat the underlying cause of pain. So the procedure is primarily diagnostic. An anesthetic is injected near the medial nerves; immediate and marked pain relief signals that the appropriate facet joint has been identified. Once the affected facet joint has been identified, we will often perform Radiofrequency Denervation to the medial branch nerves to treat the underlying condition. Skyline Physical Medicine & Rehabilitation has the training and expertise to properly diagnose and treat the many different causes of spinal pain – Request a Consultation today.
Also known as Radiofrequency Neurotomy, Radiofrequency Denervations are used to treat pain caused by inflammation in the facet joints, the small joints located between each vertebra in the neck and spine. This minimally invasive procedure uses heat to disrupt a particular nerve’s ability to transmit pain signals. At Skyline Physical Medicine & Rehabilitation we perform the procedure using x-ray/fluoroscopic guidance to enable precise positioning and treatment of the proper nerve. Radiofrequency Denervations are second-line treatments that are used when primary treatments such as physical therapy have failed to provide adequate relief. You shouldn’t have to “live with” neck and back pain – Request a Consultation today and let us get you back to living pain-free.
Intra-articular Facet Joint Steroid Injections are primarily diagnostic procedures, used to determine the exact nerve or nerve groups that are the source of pain. Under x-ray/fluoroscopic guidance, a local anesthetic and steroid are injected into the facet joints of the spine. If the pain goes away, the correct joint has been identified. Then, depending on your unique condition, we will devise a personalized treatment plan to provide long-lasting relief. At Skyline Physical Medicine & Rehabilitation we sometimes use these injections therapeutically to treat pain temporarily, making it comfortable for patients to perform physical therapy and daily living tasks. Request a Consultation today.
If a cyst forms on a facet joint – the small joints located between each vertebra in the spine – it can put pressure on nerves causing significant pain. Removing the cyst surgically is an option, but at Skyline Physical Medicine & Rehabilitation we are trained in a non-surgical, minimally invasive procedure that has very positive long-term outcomes. Performed under fluoroscopic guidance, the procedure involves injecting medications into the cyst to over-pressurize it until it breaks apart. Once the cyst is gone, the pressure and inflammation subside, and effective pain relief is achieved. For a proper diagnosis or to discuss this pain treatment option following a diagnosis, please Request a Consultation today.
Caudal Epidural Steroid Injections are an effective, non-surgical, minimally invasive treatment for lower back pain. A combination of a long-lasting steroid and a short-acting anesthetic is injected into the epidural space – the area within the spinal column that holds the spinal cord, spinal fluid and nerves. The steroid reduces inflammation while the anesthetic provides temporary pain relief, interrupting the pain-spasm cycle. Caudal Epidural Steroid Injections are most commonly used to treat Sciatica and Herniated/Bulging Discs. Please Request a Consultation and come see us at Skyline Physical Medicine & Rehabilitation for a proper diagnosis and back pain treatment plan.
There are two sacroiliac joints – one on each side connecting the right and left hip to the bottom of the spine. Inflammation within either of these joints can cause pain in the lower back, buttocks, groin or legs. Sacroiliac Joint Injections are used both diagnostically and therapeutically to confirm that the sacroiliac joint is the source of pain and to provide significant pain relief. Using x-ray/fluoroscopic guidance, long-lasting steroids, combined with short-acting anesthetics, are injected into the joint with the steroid reducing inflammation over time and the anesthetic providing immediate, temporary relief. Depending on your condition, Platelet Rich Plasma (PRP) therapy may also be used in combination with Sacroiliac Joint Injections. Please Request a Consultation at Skyline Physical Medicine & Rehabilitation to discuss a full range of hip, back and leg pain treatment options.
Diagnostic Ultrasound Examination is underused in musculoskeletal medicine, but not at Skyline Physical Medicine & Rehabilitation. We are board-certified in the use of this technique, which is highly effective for diagnosing a number of conditions involving rotator cuff, knee and elbow injuries, among other things. By providing views of soft-tissue that may not be visible on x-rays or MRIs, we can devise treatment plans that quickly and effectively treat the source of your pain and get you back to performing at your peak. Please Request a Consultation today, and if it’s clinically appropriate, we can conduct a Diagnostic Ultrasound Examination on your initial visit.
If you suffer from chronic migraine headaches, Botox injections may provide long-lasting, effective relief. Please Request a Consultation to discuss whether Botox injections are right for you.
Hands-on physical therapy is a first-line treatment for almost all musculoskeletal injuries and conditions. Whether you are looking to avoid surgery or are embarking on a post-surgical recovery plan, Skyline Physical Medicine & Rehabilitation is a place to come for a proper physical therapy plan. Our expertise in sports medicine is a benefit to athletes and non-athletes alike, and our staff is trained in the most advanced techniques for building strength and flexibility in your muscles and joints. Please Request a Consultation today, and we can begin your physical therapy on your very first visit.
Get on the road to living pain-free and performing at your best.
