Conditions We Treat
Your care begins with a thorough consultation and examination.
By integrating our philosophy of comprehensive, compassionate care with the most advanced state-of-the art treatments, the Freeman Pain Institute has achieved great success in providing patients with the pain relief they deserve. Our interventional procedures are founded on advanced training that incorporates the highest standard of care.
Disorders of the Spine:
- Slipped Disc or Ruptured Disc A.k.a. Herniated Disc
- Bulging Disc
- Sciatica “Pinched Nerves" A.k.a. Lumbar Radiculopathy / Cervical Radiculopathy / Thoracic Radiculopathy
- Low Back Pain
- Spinal Stenosis
- Neck Pain
- Failed Back & Neck Surgery A.k.a. Post-Laminectomy Syndrome
- Compression Fracture
- Sacroiliac Joint Syndrome
- Facet Joint Syndrome
- Myofascial Pain Syndrome
- Degenerative Disc Disease
Disorders of the Nervous System:
- Carpal Tunnel Syndrome
- Tarsal Tunnel Syndrome
- Peripheral Neuropathy
- Complex Regional Pain Syndrome (CRPS) A.k.a. Reflex Sympathetic Dystrophy (RSD)
- Neuropathic Pain Syndrome
- Post-Herpetic Neuralgia / Shingles
Disorders From Sports-Related Injuries:
- Rotator Cuff Injuries
- Lateral Epicondylitis (Tennis Elbow)
- Medial Epicondylitis (Golfer’s Elbow, Pitcher’s Elbow)
- Plantar Fasciitis
- Hip Bursitis (Greater Trochanter Bursitis)
Disorders from Arthritis & Joint Pain:
- Osteoarthritis A.k.a. Degenerative Arthritis, Degenerative Joint Disease
- Hip Arthritis
- Knee Arthritis
Other Pain Disorders:
Slipped Disc or Ruptured Disc A.k.a. Herniated Disc
The disc is a soft cushion that is found between each bony vertebrae of the spine. Having discs between the vertebrae allows our back to
flex and the discs also act as shock absorbers for the spine. Discs usually herniate or rupture due to age, wear and tear or sudden pressure,
such as lifting or trauma. When this occurs, the central portion (nucleus pulposus) leaks out of the outer fibrocartilaginous ring (annulus fibrosis)
causing a release of inflammatory chemical mediators often resulting in pain. Nerve roots may be pinched and irritated causing pain to shoot down the arm or leg.
Nerve pain, often referred to as “sciatica” can be treated conservatively and many people find pain relief with non-surgical treatment options such as physical
therapy, medication management as well as epidural steroid injections.
A bulging disc may occur due to age, wear and tear or sudden pressure, resulting in a pinched or irritated nerve. This may cause shooting pain down the arm
or leg region. A disc bulge is different than a herniation in that it may be part of the normal aging process. The nerve pain caused by a disc bulge can be treated
conservatively and many people find pain relief with non-surgical treatment options such as physical therapy, medication management as well as epidural
steroid injections.
Sciatica “Pinched Nerves" A.k.a. Lumbar Radiculopathy / Cervical Radiculopathy / Thoracic Radiculopathy
The term sciatica or “pinched nerves” describes pain that travels down the leg typically starting from the low back and buttock region. It may be described
as sharp, shooting in nature and possibly associated with numbness, tingling and weakness. Sciatica or “pinched nerves” is a symptom and it is typically caused
by a degenerative disc disorder, bulging or herniated disc as well as a spinal arthritic condition known as spinal stenosis. Sciatic nerve pain can be treated
conservatively and many people find pain relief with non-surgical treatment options such as physical therapy, medication management as well as epidural
steroid injections.
Low back pain is a common problem, affecting up to 90% of Americans at some point in their lifetime. Common causes of back pain may involve problems with the discs,
muscles, bones, nerves and/or joints of the spine. Factors such as poor posture, lack of exercise, stress and improper work practices may also contribute to low back pain.
The majority of low back pain will resolve in time with conservative care and is often treated in a non-surgical manner.
Spinal stenosis is a degenerative or congenital condition resulting in narrowing of the spinal canal. This narrowing causes compression and pinching of the nerve roots and commonly results in pain radiating down the arms or legs. This pain is often seen with activities such as standing and walking relieved by sitting or rest. There are numerous treatments for the symptoms of spinal stenosis ranging from medication management to non-surgical spinal procedures, such as epidural steroid injections.
Neck pain is also referred to as cervical pain. It can result from a number of causes such as whiplash, herniated disc(s), degenerative disc disease, neck strain or a pinched nerve. If neck pain involves a pinched nerve, one may feel numbness, tingling or weakness in the arm or hand. The pain is commonly dull and is associated with aching and can sometimes be worsened with neck movement. The majority of neck pain will resolve in time and with conservative care and is often treated in a non-surgical manner.
Failed Back & Neck Surgery A.k.a. Post-Laminectomy Syndrome
Failed back or neck surgery is a term that is often used to describe a patient who continues to experience pain despite having had spinal surgery. This pain condition can be caused by a number of factors and is often quite debilitating physically as well as psychologically. Some of the potential causes include: disc degeneration above or below the fusion, failure of the fusion itself causing spinal instability, scar tissue formation (epidural fibrosis) as well as a recurrence of pain at the operative level (recurrent disc herniation). The pain after surgery can be treated conservatively as many people find pain relief with interventional treatment options as well as medication management.
Compression fracture occurs when the vertebral bones of the spine break. It is usually associated with some type of trauma; however some elderly patients can fracture these bones with little or no force. It most commonly occurs in the mid or low back region and is a stable type of fracture. Most compression fractures can be treated conservatively and will resolve over time. Treatment can range from rest, wearing a back brace, pain medications, injections, and exercises for strengthening and in some cases surgery. Minimally invasive procedures such as vertebral or kyphoplasty are quite effective in reducing or eliminating the pain and are done on an outpatient same-day basis.
Neck pain is also referred to as cervical pain. It can result from a number of causes such as whiplash, herniated disc(s), degenerative disc disease, neck strain or a pinched nerve. If neck pain involves a pinched nerve, one may feel numbness, tingling or weakness in the arm or hand. The pain is commonly dull and is associated with aching and can sometimes be worsened with neck movement. The majority of neck pain will resolve in time and with conservative care and is often treated in a non-surgical manner.
The facet joints (zygapophysial or “z-joints”) are located between the vertebrae of the spine. These joints are responsible for spinal range of motion such as bending and twisting in the low back as well as rotating in the neck region. Facet syndrome results from inflammation or trauma to the area and is typically associated with stiffness, muscle spasm and pain in the spinal region. Facet joint syndrome can be treated conservatively and usually responds favorably to interventional treatments such as facet joint injections under x-ray guidance with corticosteroid as well as a more advanced procedure such as radiofrequency ablation.
Myofascial pain syndrome is a chronic musculoskeletal condition that is similar to fibromyalgia but affects the body in a more regional distribution. This condition usually involves muscle spasms, painful areas called ‘trigger points” and results in pain, restricted range of motion as well as impaired function. Treatment can range from rest, physical therapy modalities, medications, “trigger point” injections along with exercises for strengthening and endurance.
Neck pain is also referred to as cervical pain. It can result from a number of causes such as whiplash, herniated disc(s), degenerative disc disease, neck strain or a pinched nerve. If neck pain involves a pinched nerve, one may feel numbness, tingling or weakness in the arm or hand. The pain is commonly dull and is associated with aching and can sometimes be worsened with neck movement. The majority of neck pain will resolve in time and with conservative care and is often treated in a non-surgical manner.
Carpal tunnel syndrome occurs when the median nerve becomes pressed or squeezed at the wrist. This usually occurs after repetitive activities such as typing and writing but can also occur at night. The palm of the hand and the fingers, especially the thumb, index and middle fingers are usually involved and symptoms can include numbness, burning, tingling, or itching. Weakness and atrophy of the muscles can occur in severe cases and may result in dropping objects or difficulty in opening jars. Routinely a nerve test (EMG/NCS) is needed to confirm the severity of the nerve compression and treatment ranges from conservative care, bracing, physical therapy, injections and possibly surgery.
Tarsal tunnel syndrome occurs when the tibial nerve becomes pressed or squeezed at the ankle. The sole of the foot and toes are usually involved and symptoms can include pain, numbness, burning, tingling, or itching. Routinely a nerve test (EMG/NCS) can be done to confirm the severity of the nerve compression and treatment ranges from conservative care, physical therapy, injections and possibly surgery.
Peripheral neuropathy is a disease of the nervous system that affects the nerves that run into the arms, hands, legs, and feet. This condition may result in a painful burning, numbness, pins and needles as well as weakness and atrophy. There are numerous causes of peripheral neuropathy but one of the most common is from diabetes. Other causes of neuropathy include: chemotherapy, toxins or a chronic disease. There is no cure for peripheral neuropathy however, symptom management and disease regression can occur with specific medications, interventional procedures and therapeutic modalities.
Complex Regional Pain Syndrome (CRPS) A.k.a. Reflex Sympathetic Dystrophy (RSD)
Complex regional pain syndrome is a severe chronic disease that affects various parts of the body, specifically the arms and legs. It is usually precipitated by injury, trauma or surgery but has also been seen without demonstrable cause. Although the mechanism of CRPS is not known, it is believed that a central nervous system over-sensitization or “wind-up” phenomenon results in an overstimulation as well as lack of inhibition of various neurotransmitters contributing to a continuous pain cycle. The symptoms associated with CRPS include burning, electric-like shooting pains, swelling, excessive sweating, changes of the skin color and temperature as well as changes in the nails and hair. In severe cases, the bones become weak and thin, muscles may atrophy and the pain from limb movement becomes unbearable. CRPS develops in three stages depending on the progression of the disease. Treatment of this condition includes aggressive physical therapy, medications for inflammation and pain control, interventional procedures such as sympathetic blocks (stellate ganglion, lumbar sympathetic), as well as implantable therapies (spinal cord stimulators, intrathecal pain pumps).
Neck pain is also referred to as cervical pain. It can result from a number of causes such as whiplash, herniated disc(s), degenerative disc disease, neck strain or a pinched nerve. If neck pain involves a pinched nerve, one may feel numbness, tingling or weakness in the arm or hand. The pain is commonly dull and is associated with aching and can sometimes be worsened with neck movement. The majority of neck pain will resolve in time and with conservative care and is often treated in a non-surgical manner.
Neck pain is also referred to as cervical pain. It can result from a number of causes such as whiplash, herniated disc(s), degenerative disc disease, neck strain or a pinched nerve. If neck pain involves a pinched nerve, one may feel numbness, tingling or weakness in the arm or hand. The pain is commonly dull and is associated with aching and can sometimes be worsened with neck movement. The majority of neck pain will resolve in time and with conservative care and is often treated in a non-surgical manner.
The rotator cuff is a group of muscles whose function is to stabilize the shoulder joint. The four stabilizing muscles of the shoulder joint include the supraspinatus, infraspinatus, subscapularis and teres minor. The tendons of the rotator cuff become compressed from impingement which may lead to an inflamed tendon or tendonitis, or become partially or completely torn. Shoulder pain and weakness with overhead activities may develop depending on the severity of the condition. The treatment is focused on reducing the cuff inflammation, strengthening the rotator cuff muscles, corticosteroid injections, as well as arthroscopic and/or open surgery (severe complete tears).
Lateral Epicondylitis (Tennis Elbow)
Lateral epicondylitis is a chronic condition in which degenerative changes or minor tears occur at the origin of the extensor tendons of the lateral elbow or forearm region. It has been seen with repetitive activities, such as playing tennis but may occur without incident. The signs and symptoms from this condition include tenderness over the lateral epicondyle at the insertion of the extensor tendons along with pain with resisted wrist flexion. The treatment ranges from rest, icing, bracing, physical or occupational therapy, injection therapy and possibly surgical release.
Medial Epicondylitis (Golfer’s Elbow, Pitcher’s Elbow)
Medial epicondylitis is an acute or chronic condition in which degenerative changes or inflammation occurs at the origin of the flexor tendons of the elbow or forearm region. It has been seen with repetitive activities from the golf swing as well as the pitching motion. The signs and symptoms from this condition include tenderness and soreness over the medial aspect of the elbow region at the insertion of the flexor tendons in the forearm. The treatment ranges from rest, icing, bracing, physical or occupational therapy, injection therapy and possibly surgical release.
The plantar fascia is a thick, fibrous band that runs along the sole of the foot. If inflamed, severe foot and heel pain may develop which is usually worse in the morning. The diagnosis of plantar fasciitis is typically made by clinical examination with tenderness to palpation in the medial aspect of the heel and sole of the foot. Treatment may range from non-surgical modalities (rest, ice, stretching, night splints or boots, orthotics, medications) or surgical exploration.
Hip Bursitis (Greater Trochanter Bursitis)
This is a condition that involves inflammation to the bursae sac located on the lateral aspect of the hip joint. Hip pain, altered gait pattern and difficulty sleeping on the affected side are often seen. Treatment for this condition includes stretching, NSAID medications, corticosteroid injections, physical therapy and possible surgical removal of the bursae in severe refractory cases.
Osteoarthritis A.k.a. Degenerative Arthritis, Degenerative Joint Disease
Osteoarthritis is a condition which involves the degeneration of the bones and cartilage that make up the joints. It commonly involves the hips, knees, shoulders, ankles and fingers but can affect any joint in the body. The clinical manifestations from osteoarthritis include joint pain, stiffness, swelling, decreased range of motion, cracking (crepitus) and weakness from pain. The treatment for osteoarthritis ranges from rest, icing, bracing, physical or occupational therapy, joint injection therapy with corticosteroid or viscosupplemenation (Hyaluronan, Euflexxa) and possibly surgical intervention.
Injuries that occur at the workplace have a tremendous impact on both the worker as well as the employer, therefore aving an in-depth understanding of the workers’ compensation system results in the most efficient treatment leading to a safe return to work. A comprehensive treatment plan consisting of addressing work status, medication management, interventional pain procedures as well as minimally-invasive spinal procedures allows us to provide the highest quality care to our patients as well as to the case managers/adjusters.
Motor-vehicle Injuries / PIP / No Fault
Injuries that occur as a result of an accident can be quite devastating to the person involved as well as their family. Non-surgical conservative treatments will often provide the most effective way to relieve the pain that results from an accident with the goal of improving function and restoring quality of life. A comprehensive approach incorporating medication management, physical therapy, interventional pain procedures as well as minimally-invasive spinal surgery will often result in a successful treatment plan.
Fibromyalgia is a chronic condition affecting the muscle and fibrous tissue resulting in a diffuse widespread pain disorder. This condition is associated with 18 tender points located over the neck, back, hips, buttocks, knees, elbows and chest. Fibromyalgia is often associated with other conditions such as depression, anxiety as well as sleep disturbances. An aggressive treatment plan using a comprehensive approach involving physical therapy, medication management and injection therapy are often very successful in obtaining positive results.
"Dr. Freeman is an outstanding physician. He takes time to explain the exact nature and extent of treatment. I like his personal approach and I highly recommend the Freeman Pain Institute."
M.S.
Highest Standards of Care:
All procedures are done under fluoroscopic guidance (X-ray-guided) to ensure proper placement of the medication and may be performed in an ambulatory surgical center, fluoroscopy suite or hospital setting.
Health Insurance:
Most Insurance are accepted.
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