Treatments & Procedures

  Epidural steroids or " Cortisone" are commonly injected into the Lower back, but also into the Neck and Thoracic area. This is used more for "Sciatica" or pain coming down the leg or arm, but can be used for Lower back or neck pain as well. While it is true that steroids are not FDA-approved for epidural placement, they have been the standard-of-care for decades. We use only commercially manufactured Depo-Medrol with preservative and we have never had an infection or a serious reaction.

Often there is more pain in the lower back or neck than shooting down the leg or arm. This can hurt across the spectrum and at different times of the day or with different activities hurts more or less. Injecting the facet can be therapeutic as well as diagnostic and makes it possible for us to then proceed with radiofrequency or "RFA" to treat neck or back pain more effectively over a longer period of time.  No, we are not "burning the nerves" to your legs or anything like that- but this is a common misconception.

.  Radiofrequency uses the same needle as the facet block, but a tiny wire is inserted through the needle to generate electrical activity that turns to heat.  It takes a little bit longer as the generator runs through it’s cycle but the only painful part is that Dr Mike usually listed to opera during this time.  We are in effect "buzzing" the small nerves that transmit pain from your back or neck. 

This treatment can also be done for shoulder, knee and hip joints.

Acupuncture and electroacupuncture exist along the spectrum and are used in conjunction with other treatment including trigger points and osteopathic manipulation. Dr Mike has studied but is not a certified acupuncturist yet uses it on a daily basis and practices his own hybrid of Eastern and Western acupuncture.  It is particularly useful as one more tool in the toolbox for patients who are steroid sensitive, brittle diabetics or have already had considerable cortisone injections

Spinal Cord Stimulation, also known as dorsal column stimulation, involves inserting a wire with a series of magnets inside the spinal canal to generate a magnetic field and block pain. This is nondestructive, removable, and reversible. It's like setting up a "busy signal" so that pain does not travel to the brain.  This is obviously done as a temporary first (like a test drive)  and the permanent is only done if the temporary it works well. There are many different types of spinal cord stimulation and manufacturers and many factors determine which one is the right one for you.

Nearly every patient seen some form of osteopathic manual medicine. Dr. Stretanski is an osteopathic physician trained in Philadelphia and specifically went to an osteopathic medical school to become an expert in manual medicine. This could not be further from the things done by non-physician manipulators such as reiki healers, chiropractors, physical therapists and massage therapists, is done from the perspective of being an actual medical doctor and  part of a comprehensive plan of holistic care

  An implantable pain pump can be done in cases where many other treatments fail, or, early for end-of-life care. Many different medications are used including commonly known morphine but also less common medications. The pumps can also be used for patients with spasticity and tone by filling them with Baclofen. As with the stimulator, a temporary pump is first  hooked-up outside your body to demonstrate that it works before you’re taken for a permanent implant. Patients who don’t tolerate medications by mouth or are very sensitive to certain medicines usually do very well with those same medicines in the pump

There are times when the "electrical cycle of pain in the nervous system" runs away with itself. Pain is chronic, burning and light touch is felt to be painful. Sympathetic Blocks can be done at a number of "relay stations" in the body and give the body a chance to “reset” what is and is not painful. Similar to when a computer is doing something and you cannot get it to work properly you turn the computer off and give it a chance to "Reboot" for lack of better term. These blocks are also diagnostic in terms of making a diagnosis of Reflex Sympathetic Dystrophy, which may be important for more advanced care such as Spinal Cord Stimulation.

The idea of using live honeybees might sound a little crazy. But even the ancient Egyptians were using bee pollen and bee venom four thousand years ago. There’s a huge difference between honeybee venom compared to the venom from a wasp or a hornet. We do not purify or handle the venom itself, but rather, the live honeybee is placed in a similar area along what are known as acupuncture meridians. In over 12 years Dr. Mike has never had a problem with anyone being treated with honeybee stings.  This treatment is usually seasonal and the availability of healthy live bees at any time is never a guarantee.  Dr Mike is an avid BeeKeeper, but it's a tough hobby

 Kyphoplasty is a vertebral augmentation surgery to treat fractures in the vertebra.  It involves placing a needle into the fractured vertebra, inflating a balloon on the end of the needle, then deflating/removing the balloon and filling the cavity with a plastic cement - same as used for joint replacement. (The term Khyphoplasty is a registered trademark of Medtronic Corporation who manufacture the kits)

 The TruFUSE minimally invasive procedure utilizes special instruments to insert the a sterile bone dowel between the facet joints to provide immediate stabilization and relief of pain. TruFUSE can be used either as a stand-alone procedure or as an adjunct to augment other fusion techniques and motion limiting products.  You often wear a brace for 12 weeks and it is mostly for midline pain - it is NOT done for pain down the legs/sciatica

  Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient's own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. Dr Mike will draw your blood and spin in down in a centrifuge, sometimes combine it with dextrose or marcaine and shoot it back into you. In this way, PRP injections uses your own own healing system to improve musculoskeletal problems.  It avoids steroids and their side-effects but does NOT work for everything.