Interventional Pain · Regenerative Medicine · Performance
Precision medicine for your body, your pain, and the years ahead.
Whether you're navigating chronic pain that's been dismissed too many times, protecting the athletic life you've built, or asking more from your body as it changes — I've built this practice for people who want real answers, not managed symptoms. Interventional precision and a whole-body perspective, together, because how you feel today shapes how well you function for the next 30 years.
Targeted Injections
Image-guided procedures — some using live X-ray (fluoroscopy), others ultrasound — placed with anatomical precision to reach the exact structure generating your pain. The goal is never just temporary relief: an injection serves as both a diagnostic tool and a therapeutic intervention, telling us what's actually driving your symptoms.
Lumbar Epidural Steroid Injection
Lower Back & Sciatica
If you have shooting leg pain, sciatica, or the slow squeeze of a narrowed spinal canal, a lumbar epidural puts anti-inflammatory medication right next to the irritated nerve root in your low back. The most common epidural I do — and the one I'd reach for first if your pain is from the lumbar spine.
Read the full guideCervical Epidural Steroid Injection
Neck & Arm Nerve Pain
If your nerve pain is in your neck or shooting down an arm, the cervical epidural is the right tool. The cervical level needs more care than the lumbar — I do every cervical epidural under live X-ray with contrast confirmation, never blind.
Read the full guideThoracic Epidural Steroid Injection
Mid-Back & Chest-Wall Nerve Pain
Less common than cervical or lumbar, but the right tool for band-like chest-wall pain, post-shingles neuralgia, and pain from a thoracic disc problem. Same principle, mid-back level.
Read the full guideCaudal Epidural Steroid Injection
Sacral Hiatus Approach
Same medication, same destination — I just enter from below, through a small natural opening at the base of the sacrum. Particularly useful when prior back surgery has changed your lumbar anatomy or when I want medication to spread broadly across multiple lower spine levels.
Read the full guideSI Joint Injection
Fluoroscopic Guidance
The sacroiliac joint connects your sacrum to your pelvis and takes a beating with everything you do — walking, sitting, twisting. When it's inflamed, it produces back and buttock pain that's notoriously hard to tell apart from a disc problem. I inject the joint under live X-ray with contrast, which both confirms the joint as the source AND treats it. If you've had low back pain for years and nobody's been able to pinpoint it, this is often the missing piece.
Read the full guideFacet Joint Injections
Cervical & Lumbar — Fluoroscopic Guidance
The facet joints run along the back of your spine at every level. They take a beating with age and repetitive loading. Pain coming from them often shows up as neck or back pain that gets worse with extending, twisting, or sitting too long. I inject the affected joints under live X-ray with a precise mix of anesthetic and steroid. It also tells me something important: if your pain quiets down significantly, that confirms the facets as the target for longer-lasting treatment.
Peripheral Nerve Blocks
Genicular, Occipital & Extremity Nerves — Ultrasound or Fluoroscopy
Not all pain comes from the spine. Peripheral nerve blocks target the specific sensory nerves feeding a painful joint or region — the genicular nerves around the knee, the occipital nerves at the base of the skull, or branches in the extremities. I use ultrasound or live X-ray to place these precisely. They're also diagnostic: a clear positive response tells me exactly which nerves to target if you eventually need longer-term ablation.
Ultrasound-Guided Injections
Nerves · Bursae · Peripheral Joints
For nerves, bursae, and peripheral joints — outside the spine — ultrasound is the right imaging tool. I see the anatomy and the needle in real time, with no radiation. One consolidated page covers what I treat: suprascapular nerve blocks, trochanteric bursa, hip joint, shoulder, and many others. Office-based, no driver required for most.
Read the full guideTrigger Point Injections
Palpation or Ultrasound Guidance
Trigger points are hyperirritable knots in muscle that produce both local tenderness and referred pain that can mimic nerve or joint problems. They're common in chronic neck pain, tension headaches, myofascial pain syndrome, and overuse injuries — and they can perpetuate a pain cycle that resists other treatment. A small injection of local anesthetic placed directly into the trigger point — by feel or under ultrasound — disrupts that cycle and releases the muscle. Often a quietly powerful add-on to a broader plan.
Ablation & Nerve Procedures
When targeted injections confirm a nerve as the pain generator, the next logical step is turning it off more durably. I use either radiofrequency energy or precisely applied cold to disrupt the nerve's ability to transmit pain — providing relief that outlasts any injection, often by months to over a year. Both are outpatient, minimally invasive, and done under image guidance.
Lumbar Facet RFA
Low Back · 6–18 Months Relief
I use targeted heat to interrupt the medial branch nerves that carry pain signals from your lumbar facet joints. The joints stay; the pain pathway is what changes. Six to eighteen months of relief from a single treatment for the right candidates.
Read the full guideCervical Facet RFA
Neck · 6–18 Months Relief
Same principle as lumbar RFA, applied at the cervical level. The medial branches in your neck sit close to important structures, so I use live X-ray plus sensory and motor testing at every level. For axial neck pain confirmed by diagnostic blocks, this is one of the most durable non-surgical tools I have.
Read the full guideCryoablation
Cold-Based Nerve Disruption · Peripheral Nerves
Where radiofrequency uses heat, cryoablation uses precisely targeted extreme cold to interrupt peripheral nerve function. A specialized probe delivers very low temperatures to the nerve, causing controlled disruption of pain transmission while keeping the surrounding connective tissue intact. Because the nerve sheath is preserved, regeneration is more organized — and many patients have a smoother course than with heat-based techniques. Especially well-suited to peripheral nerves where I want long relief without affecting motor function.
Neuromodulation
The frontier of non-destructive pain treatment — using calibrated electrical signals to change how the nervous system processes pain, without cutting, ablating, or permanently altering anything. Drug-free, fully reversible. For the right patients, this is not a last resort. It's a smarter route.
Spinal Cord Stimulation (SCS)
Implantable · Reversible · Drug-Free
SCS delivers mild electrical pulses to the dorsal columns of the spinal cord, modulating pain signals before they reach the brain. The evidence is strong for complex regional pain syndrome (CRPS), failed back surgery syndrome, and stubborn neuropathic and radicular pain. Modern systems — including high-frequency and burst modes — produce relief without the older-generation "tingling" sensation. We do a trial period first so you can evaluate the result before committing to anything permanent. The system can be adjusted, reprogrammed, or removed at any time.
Dorsal Root Ganglion (DRG) Stimulation
Focal Precision · Foot, Knee, Groin
DRG stimulation puts neuromodulation right at the dorsal root ganglion — the cluster of sensory neurons controlling input from a specific body region. That precision makes it exceptionally good for focal, hard-to-treat pain: foot pain, post-surgical knee pain, groin pain after hernia repair, complex ankle pathology. Where standard SCS can give incomplete coverage of these peripheral regions, DRG is built specifically for them. For patients with well-localized, treatment-resistant pain that's been hard to target, this technology has been life-changing.
Peripheral Nerve Stimulation (PNS)
Outside the Spine · Targeted & Reversible
PNS brings neuromodulation out of the spine entirely. I place a small electrode alongside a specific peripheral nerve to modulate its activity and interrupt the pain signal at the source. Applications include occipital neuralgia, chronic headache, shoulder pain after rotator cuff disease, chronic knee pain, and post-amputation phantom limb pain. Leads go in percutaneously under imaging guidance. Trial systems are fully external and reversible. For patients who've been told their options are exhausted, PNS often opens a door that wasn't on anyone's map.
Minimally Invasive Surgery
Some conditions need structural correction — not just symptom management. The bridge between interventional pain care and the fix that actually resolves the underlying problem.
SI Joint Fusion
Minimally Invasive · Structural Stabilization
When SI joint dysfunction has progressed past what injections can reliably control, fusion offers a durable structural solution. I use minimally invasive technique — small incision, live X-ray, implants designed specifically for SI stabilization — to fuse a joint that's lost its ability to hold itself together. This isn't a repeat of what you've already tried. It's a different category of intervention aimed at correcting the architecture, not quieting the inflammation. For carefully selected patients who've exhausted conservative care, the outcomes are among the most meaningful I see.
Regenerative Medicine
Regenerative medicine isn't about masking pain — it's about giving your tissue the biological signals it needs to repair, remodel, and function the way it was designed to. For active patients, athletes, and anyone invested in long-term physical performance, this is where pain treatment meets tissue optimization.
Platelet-Rich Plasma (PRP)
Your Own Biology · Ultrasound-Guided Precision
PRP is made from your own blood — a concentrated preparation of platelets and growth factors that I inject precisely into an injured or degenerating structure to stimulate your natural repair process. The evidence base keeps growing for rotator cuff tendinopathy, patellar tendon injuries, lateral epicondylitis (tennis elbow), and knee osteoarthritis in patients who want to extend their functional years before considering joint replacement. Under ultrasound, placement is exact. PRP won't reverse severe structural damage — but for the runner managing early knee arthritis, the weekend athlete whose elbow won't heal, or anyone in their 40s and 50s who isn't ready to stop, it can be a meaningful part of staying in the game.
Performance & Longevity
Something changes in your 40s that no one fully prepares you for.
It's not dramatic. It's gradual. Recovery takes a day longer. The shoulder that used to bounce back now lingers. Sleep gets worse, body composition shifts despite doing everything right, and tissue that used to be resilient starts to remind you it's there. I see this pattern constantly, and I want to be direct: this isn't weakness. It's biology. Hormonal shifts — in both men and women — alter how we build and maintain muscle, how efficiently we burn fuel, and how quickly injured tissue repairs. The musculoskeletal system isn't immune to metabolic change.
What that means clinically is that treating pain in a 48-year-old isn't the same as treating it in a 28-year-old. It needs me thinking about the whole system — recovery capacity, inflammation burden, tissue quality, and the downstream effects of hormonal transitions. Post-menopausal women and men navigating the slow decline in testosterone face their own distinct challenges that most pain practices simply aren't equipped to contextualize.
There's a growing body of evidence around approaches designed to support this: how certain nutritional strategies, compounds, and recovery interventions interact with an aging but capable physiology. I find this space genuinely fascinating, and I write about it regularly. The blog is where I go deeper — no protocol sales, no hype, just rigorous thinking about what the science actually supports and what questions are still worth asking.
If any of this resonates, following the blog is the most useful thing I can offer you right now.
Where the real conversation happens
The blog is where I write about pain, performance, longevity, and the science that connects them — topics that rarely fit into a 20-minute appointment. If you want the thinking behind the medicine, this is where it lives.
Read the blog