We employ a multimodal pain management philosophy with a focus on Interventional Pain Management Therapies including injections, radiofrequency ablation, vertebral augmentation, neuromodulation, regenerative medicine and other minimally invasive surgeries like sacral fixation and lateral approach posterior fusion. We can also refer to our Neurosurgery and Spine Practice when appropriate. Other therapies may include physical therapy, braces, medications and referral to psychiatry for coping techniques or other specialists as needed. We also encourage weight loss and smoking cessation when indicated. Insurances require certain conservative treatments or assessments be performed within very specific time frames (eg Physical Therapy or MRI within 30 days, 90 days, or 365 days) in order to have advanced therapies approved.

We perform a broad variety of minimally invasive treatments including injections, radiofrequency ablation, vertebral augmentation to treat compression fractures, neuromodulation, regenerative medicine and other minimally invasive surgeries like sacral fixation to treat sacroiliac joint pain and lateral approach posterior fusion that treats a number of spine disorders including pain related to instability of the spine including stenosis, spondylolisthesis, and facet joint instability.

Most procedures are only a few minutes in duration and can be safely performed using a local anesthetic. We will play music and talk you through the procedure. Conscious sedation is available in most cases. With conscious sedation a mild sedative is administered either by mouth or intravenous injection. The patient is monitored for safety and will need a driver to accompany them. Our more invasive procedures may require a deeper level of sedation and will also require a driver. Sedation is often covered by insurances and is available out-of-pocket when not covered by insurance.

Most procedures will result in localized soreness similar to the discomfort experienced after having a vaccine or blood drawn. This is mild. The next most common cause of pain following a procedure is muscle spasm and typically resolves after a few days. Heat, massage, and over-the-counter pain medications like Acetaminophen or Ibuprofen can help with this.

Some medications may need to be stopped or changed prior to surgery. You will be given instructions ahead of time. If you are not sure what to do, you should check with your provider to make sure.

The opioid epidemic is an ongoing health concern. Our focus is to help patients manage their pain using Interventional Therapies and non-opioid alternatives. Most Interventional Pain therapies are non-permanent providing variable degrees and duration of pain relief. Opioids may be used to supplement these treatments, but are NOT relied upon as the sole means of managing a patient's pain. When opioids are used we utilize the lowest possible dose clinically indicated and actively pursue opportunities to deescalate or discontinue opioid therapy as indicated.

In general, opioids are written in one (1) month intervals. This allows us to perform mandated monitoring and safety assessments. All other medications will vary based upon clinic considerations or provider discression.

Medications should ONLY be taken as prescribed by your medical provider. All medications have the potential for harm when taken as prescribed, not other than as prescribed, or when discontinued abruptly. It is important to update your medication and supplement list with us to help minimize drug interactions.
When opioids are prescribed, we provide education, review medications, and monitor patients with frequent office assessments, laboratory screening, and pill counts. We may also refer you for sleep studies and ECG when indicated.

Benzodiazepines, alcohol, and sleep aides significantly increase the risk of harm when used in conjunction with opioids. We strongly recommend avoiding using these medications together.

You may not drive while under the influence of a controlled substance like opioid pain medicines.

Pain is very complex and there are many different treatment options available to treat various types of chronic pain complaints. We will work with you to identify a program that provides pain relief.

We employ a team based approach incorporating highly trained Nurse Practitioners and Physician's Assistants skilled in treating chronic pain under the direction and supervision of fellowship trained Board Certified Physicians.

Prescriptions for both controlled and non-controlled substances are required to be sent electronically in the State of Florida. There are limitations imposed on who can send controlled substances. Because of this, our commitment is to send prescriptions within 48 hours.

You can attempt to contact our office. If you have a delay in speaking with a representative or are experiencing swelling of the lips, face, rash, or trouble breathing you should go to the Emergency Department for immediate evaluation.

You may call our office. We are an out-patient facility and are unable to manage acute changes. We may refer you to the Emergency Department for evaluation. In addition, if you have a delay in speaking with someone you should go to the Emergency Department for immediate evaluation.

Our Pain Management team is not trained in functional evaluations for disability of any kind. We do NOT complete ANY forms. These should be directed to your PCP or surgeon.

We will provide a work excuse for office or surgery appointments. Extended work excuses are ONLY provided when directed to do so by a provider BEFORE the absence occurs. We WILL NOT provide work excuses for absences occurring prior to provider approval.

FOR ACDF on side or back (not on stomach) Or FOR TLIF any way that is comfortable

Will be e-faxed to pharmacy from SHH, or on Chart at FWB

Will be the worst first 2-3 days, spasms. Improve over next two weeks. Will slowly improve as restarts PT two weeks post op. Worse pain first 2 weeks post op then improve.

All @midnight, day of surgery. Anticoagulant, NSAIDS, Fish Oil, Vitamin E has to be stopped 7 days prior to surgery.

Regular medicine when discharged from the hospital. Anti-inflammatory 3-6 months

Patient must wait after 2 weeks post-op appointment to discuss. Walking only.

no, wait two weeks post op after surgery. Wear C-collar at all times when standing x 2 weeks.

yes after 48 hrs., remove bandage and pat dry. No submersion in bodies of water.

No. Until incision completely healed, after two week post op appt.

When off narcotics and can turn to see blind spots.

No , just when ambulating, feet on the ground - wear collar

3-10 days post op, but may last few months depending on healing or any vocal cord stretching during surgery

No, better over time. Eat small bits and drink slowly. Ice chips and ice cream can help. Use chloraseptic spray (OTC)

few weeks, can Ice

No, only if pus or weeping. Can use Ice to help with swelling

call office and make appt to be seen

only remove after surgery as directed , no dressings needed after initial. If put it on for comfort, it must be changed daily. If any staples leave them,

Not until seen post op appt.

Not til complete healed and cleared by surgeon, 3-6 months post op (for the are of surgery)

6 weeks.

until battery dies, on at all time

after first post op visit

3-D porous titanium

over night , depending on surgery or if any surgical complications

Depending on post op symptoms, Case management at the hospital will work on evaluation and recommendations after surgery.

no

two weeks post op after steri-strips come off (can shave around it)

Anesthesia may mess with your sleep cycle, you may get insomnia or irregular sleep cycle. Ok to take Tylenol PM, avoid sleep aids unless you already have had them with Narcotic medications as they may have an additive effect.